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RYAN SHAKE O.D. NPI 1457707911


NPI Information

NPI: 1457707911
Provider Name: RYAN SHAKE, O.D.
Classification: Optometrist - 152W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2000 COASTAL GRAND CIR
MYRTLE BEACH, SC
ZIP 29577
Phone: (843) 444-0900
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Ryan Shake, O.D. is an optometrist in Myrtle Beach, SC with 10 years of experience. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. Ryan Shake, O.D. NPI is 1457707911. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: INTERNATIONAL AMERICAN UNIVERSITY AT PUERTO RICO - SCHOOL OF OPTOMETRY
Graduation Year:2014

The provider's business location address is:

2000 COASTAL GRAND CIR
MYRTLE BEACH, SC
ZIP 29577-798
Phone: (843) 444-0900

The NPI 1457707911 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 5/13/2016 and was last updated on 5/13/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristSC1934SOUTH CAROLINAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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