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NPI Code Detail

MEDICARE: DR. SHANNON SCHAEFER KESSLER O.D.

MEDICARE: DR. SHANNON SCHAEFER KESSLER O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2651CO
2152W00000XOptometrist3229ATIOR
3152W00000XOptometristOD 60031965WA
4152WL0500XLow Vision Rehabilitation Optometrist2651CO

General Provider Information

NPI Number : 1588856058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON SCHAEFER KESSLER O.D.
Provider Business Mailing Address
First Line : 14400 E JEWELL AVE
Second Line :
City : AURORA
State : CO
Zip : 80012-5689
Country : US
Telephone Number : 303-270-6407
Fax Number : 303-751-0171
Provider Business Practice Location Address
First Line : 14400 E JEWELL AVE
Second Line :
City : AURORA
State : CO
Zip : 80012-5689
Country : US
Telephone Number : 303-270-6407
Fax Number : 303-751-0171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2007
Last Update Date : 04/20/2023

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