Shelton Family Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD 60292781 Issued in WA

Legal business name

SHELTON FAMILY EYE CARE, LLC

Practice address

100 E Wallace Kneeland Blvd
Shelton, WA 98584-2981

Phone

(360) 427-8325

Fax

(360) 427-8326

NPI assigned

Sep 4, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven La, ODNPI 1679838874

Title

Optometrist

Phone

(360) 601-7796

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven La, O.D.

  • Optometrist
  • Shelton, WA
  • NPI 1679838874
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346716800000",
    "number": "1780933945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E WALLACE KNEELAND BLVD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842981",
            "telephone_number": "360-427-8325",
            "fax_number": "360-427-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E WALLACE KNEELAND BLVD",
            "city": "SHELTON",
            "state": "WA",
            "postal_code": "985842981",
            "telephone_number": "360-427-8325",
            "fax_number": "360-427-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON FAMILY EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-04",
        "last_updated": "2012-09-04",
        "status": "A",
        "authorized_official_last_name": "LA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "360-601-7796",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "WA",
            "license": "OD 60292781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1679838874",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jackie Shaffer
• Resa Shaner, PA-C
• Shelton Assisted Living
• Shelton Chiropractic and Wellness LLC
• Shelton Family Center
• Shelton Family Medicine P.L.L.C.
• Shelton Family Medicine PLLC
• Shelton Physical Therapy and Sports Medicine Clinic P.S.
• Shelton School District
• Shelton SNF Operations, LLC

• Optometrist in Shelton, WA
• Providers in Shelton, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.