Individual provider Active NPI

Carla S Shorter, O.D.

  • Optometrist
  • Beavercreek, OH
National Provider Identifier
1831124155
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TN2532 Issued in TN
Practice address
2242 Turnbull Rd
Beavercreek, OH 45431-3221
Phone
(423) 202-0971
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TN2532 TN Primary
Corneal and Contact Management Optometrist 152WC0802X TN2532 TN
Low Vision Rehabilitation Optometrist 152WL0500X TN2532 TN
Pediatric Optometrist 152WP0200X TN2532 TN
Vision Therapy Optometrist 152WV0400X TN2532 TN
Occupational Vision Optometrist 152WX0102X TN2532 TN

Addresses

Primary practice location

2242 Turnbull Rd
Beavercreek, OH 45431-3221

Mailing address

2242 Turnbull Rd
Beavercreek, OH 45431-3221
Phone (423) 202-0971

Other identifiers 3

IdentifierTypeStateIssuer
4115353OtherTNBCBS
5979OtherOHOHIO LICENSE
TN2532OtherTNEYEMED

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TN2532TNMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc Past Accepting new patients
Dr. Torrey J. Carlson & Associates Optometrist PastSince Jul 28, 2003 Accepting new patients
Patrick D. Shorter Optometrist Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1831124155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 TURNBULL RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313221",
            "telephone_number": "423-202-0971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 TURNBULL RD",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454313221",
            "telephone_number": "423-202-0971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORTER",
        "first_name": "CARLA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "TN2532",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TN",
            "license": "TN2532",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "TN",
            "license": "TN2532",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "TN",
            "license": "TN2532",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "TN",
            "license": "TN2532",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "TN",
            "license": "TN2532",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4115353",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "5979",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "TN2532",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beavercreek, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.