Shelby Henderson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2177DT Issued in KY

Practice address

4051 Nicholasville Rd
Lexington, KY 40503-4433

Phone

(859) 272-1422

Fax

(859) 273-4582

NPI assigned

Jul 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Max PLLCGroup PAC ID 7810944634, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eye Max PLLC

  • Optometrist
  • Lexington, KY
  • NPI 1144362559
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1861019283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4051 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034433",
            "telephone_number": "859-272-1422",
            "fax_number": "859-273-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4051 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405034433",
            "telephone_number": "859-272-1422",
            "fax_number": "859-273-4582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W New Circle Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405111833",
            "country_code": "US",
            "telephone_number": "859-225-4657",
            "fax_number": "859-225-8366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1024 N Main St",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403562311",
            "country_code": "US",
            "telephone_number": "859-881-5444",
            "fax_number": "859-881-3180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SHELBY",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2177DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leann Henderson, RBT
• Loretta Mae Henderson, BSW
• Lynsey Brooke Ham Henderson, APRN
• Olivia Lauren Henderson, MD
• Robert T Henderson, RN,CRNFA
• Stacey Henderson
• David James Hendren, APRN
• Hendricks Family & Cosmetic Dentistry
• Hendricks Family & Cosmetic Dentistry
• Don-Michael Hendricks, D.M.D.

• Optometrist in Lexington, KY
• Providers in Lexington, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.