Shaffer Eye Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

695 Issued in MS

Legal business name

SHAFFER EYE CLINIC

Practice address

5203 Highway 11 N
Ellisville, MS 39437-5001

Phone

(601) 428-4420

Fax

(601) 425-9018

NPI assigned

Apr 9, 2008

Last updated

Apr 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Curtis J Shaffer, O.D.NPI 1679611446

Title

Owner

Phone

(601) 428-4420

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Curtis J. Shaffer, O.D.

  • Optometrist
  • Hattiesburg, MS
  • NPI 1679611446
  NPD (past) Authorized official

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1851564017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 HIGHWAY 11 N",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394375001",
            "telephone_number": "601-428-4420",
            "fax_number": "601-425-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5203 HIGHWAY 11 N",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394375001",
            "telephone_number": "601-428-4420",
            "fax_number": "601-425-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAFFER EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-428-4420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09016268",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carley Renee Robinson, CPNP
• Joanne Robinson, IDD WAIVER SERVICES
• Jacqueline Rogers, IDD WAIVER SERVICES
• Donald Scoggin, FNP
• Jay Scoggin, RPH
• Shaffer's Optical Express
• Courtney J. Sims, FNP-C
• Marilyn Smith, CIDDT
• Stephanie D. Smith, CFNP
• South Central Clinics, Inc (Ellisville Medical Clinic)

• Clinic/Center in Ellisville, MS
• Providers in Ellisville, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.