NPIMap

Organization Active NPI

Shepherd Eye Center, LTD

Doing business as NV Eye Surgery

  • Ophthalmology Physician
  • Henderson, NV
National Provider Identifier
1881321388
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SHEPHERD EYE CENTER, LTD
Doing business as
NV Eye Surgery
Practice address
2390 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5084
Phone
(702) 825-2085
Fax
(702) 852-5743
NPI assigned
Aug 4, 2022
Last updated
Jan 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SHEPHERD EYE CENTER, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Authorized official

Name
Amy Grim
Title
Regional Credentialing Manager
Phone
(702) 202-4776

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

2390 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5084

Mailing address

2390 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5084
Phone (702) 825-2085

Other practice location 1

7190 Smoke Ranch Rd Ste 110
Las Vegas, NV 89128-8398
Phone (702) 825-2085

Other names 1

  • NV Eye Surgery Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040420001820 NV Part B Supplier - Clinic/Group Practice 9234125907 Receives reassigned benefits from 42 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Vegas, NV; Pahrump, NV; Mesquite, NV; Henderson, NV; Boulder City, NV

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
John R Shepherd MD LTD4 organizations share this tax ID, including this one
Part of
John R Shepherd MD LTD

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1659571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704240000000",
    "number": "1881321388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525084",
            "telephone_number": "702-825-2085",
            "fax_number": "702-825-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525084",
            "telephone_number": "702-825-2085",
            "fax_number": "702-852-5743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7190 Smoke Ranch Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891288398",
            "country_code": "US",
            "telephone_number": "702-825-2085",
            "fax_number": "702-852-5743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHEPHERD EYE CENTER, LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHEPHERD EYE CENTER, LTD",
        "enumeration_date": "2022-08-04",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A",
        "authorized_official_last_name": "GRIM",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "REGIONAL CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "702-202-4776"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NV Eye Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NV Eye Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.