Shannon L W Clark Leitenbauer (NPI# 1760401632, PAC ID# 7517057854) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is OPTOMETRY.
| Nation Provider ID (NPI) | 1760401632 |
| PAC ID by PECOS | 7517057854 |
| Professional Enrollment ID | I20080920000065 |
| Full Name | Shannon L W Clark Leitenbauer |
| Organization Legal Name | SHANNON L CLARK OD, P.A |
| Address |
2305 Oleander Blvd Fort Pierce FL 34982-5830 |
| Phone Number | 7724656616 |
| Gender | F |
| Graduation Year | 1996 |
| Primary Specialty | OPTOMETRY |
| Group Practice PAC ID | 6901976943 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 2305 Oleander Blvd, Fort Pierce, FL 34982-5830 | 7724656616 | SHANNON L CLARK OD, P.A |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_012_overall | Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation | 100% | |
| MIPS_EC_014_overall | Age-Related Macular Degeneration (AMD): Dilated Macular Examination | 100% | |
| MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
| MIPS_EC_140_overall | Age-Related Macular Degeneration (AMD): Counseling on Antioxidant Supplement | 100% | |
| MIPS_EC_226_overall | Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 100% |
| Organization Legal Name | SHANNON L CLARK OD, P.A |
| Physicians | 2 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly J Waddell | Optometry | Shannon L Clark Od, P.a | 2305 Oleander Blvd, Fort Pierce, FL 34982-5830 |
| Street Address |
2305 OLEANDER BLVD |
| City | FORT PIERCE |
| State | FL |
| Zip | 34982-5830 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelly J Waddell | Optometry | Shannon L Clark Od, P.a | 2305 Oleander Blvd, Fort Pierce, FL 34982-5830 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David W Shaw | Chiropractic | 1006 Virginia Ave, Fort Pierce, FL 34982-3522 | |
| Andrew David Lonabaugh | Podiatry | Paul N Gotkin and David A Gubernick Dpm Pa | 1090 Virginia Ave, Fort Pierce, FL 34982-3640 |
| Scott Joseph Cohen | Podiatry | Paul N Gotkin and David A Gubernick Dpm Pa | 1090 Virginia Ave, Fort Pierce, FL 34982-3640 |
| David Gubernick | Podiatry | Paul N Gotkin and David A Gubernick Dpm Pa | 1090 Virginia Ave, Fort Pierce, FL 34982-3640 |
| Paul Gotkin | Podiatry | Paul N Gotkin and David A Gubernick Dpm Pa | 1090 Virginia Ave, Fort Pierce, FL 34982-3640 |
| Justine Taylor Theisen | Speech Language Pathologist | 5811 Bamboo Dr, Fort Pierce, FL 34982-3758 | |
| Pandora A. Scotto | Clinical Social Worker | Step By Step Counseling Services, LLC | 776 W Midway Rd, Fort Pierce, FL 34982-4203 |
| Debbie K Hoeffner | Clinical Social Worker | Step By Step Counseling Services, LLC | 776 W Midway Rd, Fort Pierce, FL 34982-4203 |
| John Deiner | Chiropractic | Ocean Chiropractic and Health Center Inc | 805 Virginia Ave, Suite 11, Fort Pierce, FL 34982-5881 |
| Syed Shafeeq Ur Rahman | Internal Medicine | 805 Virginia Ave, Suite 16, Fort Pierce, FL 34982-5881 | |
| Find all physicians in zip 34982 | |||
| City | FORT PIERCE |
| Zip Code | 34982 |
| Specialty | OPTOMETRY |
| City + Specialty | FORT PIERCE + OPTOMETRY |
Please comment or provide details below to improve the information on Shannon L W Clark Leitenbauer.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.