Shannon D. Fowler, OD, PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3113 Issued in FL

Legal business name

SHANNON D. FOWLER, OD, PA

Practice address

4418 Commons Dr E
Ste a
Destin, FL 32541-8406

Phone

(850) 654-3937

Fax

(850) 654-1070

NPI assigned

Dec 4, 2007

Last updated

Mar 16, 2010By 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. Shannon Fowler, O.D.

Title

President

Phone

(850) 654-3937

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1902088677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 COMMONS DR E",
            "address_2": "STE A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418406",
            "telephone_number": "850-654-3937",
            "fax_number": "850-654-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4418 COMMONS DR E",
            "address_2": "STE A",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418406",
            "telephone_number": "850-654-3937",
            "fax_number": "850-654-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON D. FOWLER, OD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-654-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Destin, FL
• Providers in Destin, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.