Provider Demographics
NPI:1831135797
Name:SHEWRING, JENNIFER ERIN (OD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ERIN
Last Name:SHEWRING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 E TOWN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4856
Mailing Address - Country:US
Mailing Address - Phone:614-461-1885
Mailing Address - Fax:614-461-5730
Practice Address - Street 1:1070 POLARIS PKWY STE 110
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4039
Practice Address - Country:US
Practice Address - Phone:614-880-1493
Practice Address - Fax:614-880-1493
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5573152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2661365Medicaid
OHSH4174621Medicare ID - Type UnspecifiedMEDICARE ID #
OH4245430001Medicare NSC
OHV08033Medicare UPIN
OHPR9297781Medicare PIN