Active NPI
Susan-Hyonji Shin, OD
- Optometrist
- Fort Myers, FL
National Provider Identifier
1912948100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3727
- Practice address
- 3033 Winkler Ave
Fort Myers, FL 33916-9413 - Phone
- (239) 939-3939
- NPI assigned
- Jun 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3727 | FL | Primary |
| Low Vision Rehabilitation Optometrist | 152WL0500X | 3727 | FL |
Addresses
Primary practice location
3033 Winkler Ave
Fort Myers, FL 33916-9413
Mailing address
3033 Winkler Ave
Fort Myers, FL 33916-9413
Phone (239) 939-3939
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3727 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1912948100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3033 WINKLER AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169413",
"telephone_number": "239-939-3939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 WINKLER AVE",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169413",
"telephone_number": "239-939-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "SUSAN-HYONJI",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-09",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "3727",
"primary": true
},
{
"code": "152WL0500X",
"taxonomy_group": "",
"desc": "Optometrist, Low Vision Rehabilitation",
"state": "FL",
"license": "3727",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.