Optical Boutique Family Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

OPTICAL BOUTIQUE FAMILY EYECARE

Practice address

2109 West St
Germantown, TN 38138-3833

Phone

(901) 754-6020

NPI assigned

Nov 10, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Brister Shum

Title

Manager

Phone

(901) 754-6020

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 3

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

• Danielle Zasoski Hebert, OD

  • Optometrist
  • Germantown, TN
  • NPI 1831768407
  Medicare reassignment Care Compare group NPD
• Andrew Meyer Shum, O.D.

  • Optometrist
  • Germantown, TN
  • NPI 1528414547
  Medicare reassignment Care Compare group NPD
• Steven R. Shum, O.D.

  • Corneal and Contact Management Optometrist
  • Germantown, TN
  • NPI 1710991872
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1699574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699574400000",
    "number": "1891569711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2109 WEST ST",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383833",
            "telephone_number": "901-754-6020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 WEST ST",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383833",
            "telephone_number": "901-754-6020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL BOUTIQUE FAMILY EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-10",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A",
        "authorized_official_last_name": "SHUM",
        "authorized_official_first_name": "BRISTER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "901-754-6020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mabel Beard Olaya, NP
• Kevin Martin Olds, MSPT
• Jerald Olvido, MT
• Nicole Amara Mansa Onuoha, MD, MPH
• Iluobe Onuora, OT
• Optum Behavioral Care of North Carolina, PC
• Optum Behavioral Care of North Carolina, PC
• Optum Behavioral Care of North Carolina, PC
• Mary Griffin Orians, APN, FNP
• Sarah Kathryn Orians

• Optometrist in Germantown, TN
• Providers in Germantown, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2023; 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.