Nadira Soad Shadeed, O.D., F.C.O.V.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

2355 Issued in GA

Practice address

2055 Hamilton Creek Pkwy Ste 120
Dacula, GA 30019-7205

Phone

(770) 904-0979

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Pediatric Vision Development Center of Forsyth

  • Vision Therapy Optometrist
  • Cumming, GA
  • NPI 1659789923
  NPD (past)
• Pediatric Vision Development Center of Gwinnett

  • Vision Therapy Optometrist
  • Dacula, GA
  • NPI 1669880936
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1952411969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 HABERSHAM CLUB DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300418003",
            "telephone_number": "678-448-2696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 HAMILTON CREEK PKWY STE 120",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300197205",
            "telephone_number": "770-904-0979"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 Ronald Reagan Blvd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Cumming",
            "state": "GA",
            "postal_code": "300417578",
            "country_code": "US",
            "telephone_number": "770-904-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHADEED",
        "first_name": "NADIRA",
        "middle_name": "SOAD",
        "name_prefix": "Dr.",
        "credential": "O.D., F.C.O.V.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "2355",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1440",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "SC",
            "license": "1440",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "GA",
            "license": "2355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D14401",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charlotte A Scott, CLD
• David Scott, RPH
• See Chung Mental Health Services LLC
• Marissa Sellers, PT
• Minkailu Sesay, MD
• Henna Shah, PHARMD
• Christine Marie Shaheen-Ball, M. S., LPC
• Dustin Leigh Shandy, LPC
• Stephanie Sheets, LPC
• Jessica Stephens Shelnutt, PT, DPT

• Vision Therapy Optometrist in Dacula, GA
• Providers in Dacula, GA by specialty
• Vision Therapy Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.