Provider Demographics
NPI:1982837852
Name:THEA T. SHEARER, OD
Entity Type:Organization
Organization Name:THEA T. SHEARER, OD
Other - Org Name:CLEARSIGHT OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THEA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHEARER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:859-624-2015
Mailing Address - Street 1:5019 ATWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8898
Mailing Address - Country:US
Mailing Address - Phone:859-624-2015
Mailing Address - Fax:859-624-4415
Practice Address - Street 1:5019 ATWOOD DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8898
Practice Address - Country:US
Practice Address - Phone:859-624-2015
Practice Address - Fax:859-624-4415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1478DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP100023986Medicare PIN
KY6313950001Medicare NSC
KYDQ8644Medicare PIN