Organization Active NPI

Steven & Donna Shepard

  • Optometrist
  • Austin, TX
National Provider Identifier
1992907349
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3985T AND 3986T Issued in TX
Legal business name
STEVEN & DONNA SHEPARD
Doing business as
Austin Vision Associates
Practice address
11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097
Phone
(512) 343-0406
Fax
(512) 343-1093
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Authorized official

Name
Mrs. Deborah T Sands
Title
Office Manager
Phone
(512) 343-0406

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3985T AND 3986T TX Primary

Addresses

Primary practice location

11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097

Mailing address

11410 Jollyville Rd
Suite 3201
Austin, TX 78759-4097
Phone (512) 343-0406

Other identifiers 1

IdentifierTypeStateIssuer
00E09MOtherTXBCBS

Other names 1

  • Austin Vision Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000726 TX Part B Supplier - Clinic/Group Practice 5890956551 Receives reassigned benefits from 2 practitioners
Practice locations: Austin, TX

National Provider Directory

National Provider Directory

Locations

11410 Jollyville Rd
Ste 3201
Austin, TX 78759
Phone (512) 343-0406

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368662400000",
    "number": "1992907349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 JOLLYVILLE RD",
            "address_2": "SUITE 3201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594097",
            "telephone_number": "512-343-0406",
            "fax_number": "512-343-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 JOLLYVILLE RD",
            "address_2": "SUITE 3201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787594097",
            "telephone_number": "512-343-0406",
            "fax_number": "512-343-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVEN & DONNA SHEPARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2013-05-16",
        "status": "A",
        "authorized_official_last_name": "SANDS",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "512-343-0406",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "3985T AND 3986T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00E09M",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Austin Vision Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; 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.