1. Home
  2. Directory
  3. Florida
  4. Fort Pierce
  5. Eyewear Supplier
  6. NPI Profile

SHANNON L CLARK O D P A
NPI 1770767733
Eyewear Supplier in Fort Pierce, FL

Active since December 26, 2007
2305 OLEANDER BLVD, FORT PIERCE, FL 34982(772) 465-6616 Get Directions Write a Review

NPPES record last updated: July 29, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shannon L Clark O D P A NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON L CLARK O D P A (NPI 1770767733) is a healthcare organization registered as an eyewear supplier in Fort Pierce, Florida and active in the NPI registry since December 2007. The organization lists Shannon L W Clark Leitenbauer, President/owner, as its authorized official.

NPPES Registry Identity

NPI1770767733
Entity TypeOrganization
Primary Taxonomy332H00000X
Legal Business NameSHANNON L CLARK O D P A
Location Address2305 OLEANDER BLVDFort Pierce, FL 34982-5830
Mailing Address2305 Oleander BlvdFort Pierce, FL 34982-5830 · (772) 465-6616
Phone(772) 465-6616
Organization SubpartNo
Authorized OfficialShannon L W Clark LeitenbauerPresident/owner · (772) 465-6616
Enumeration DateDecember 26, 2007
Last NPPES UpdateJuly 29, 2008
✔ NPI 1770767733 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers
Taxonomy Code332H00000X
License✔ Licensed in FL · OPC 0003067
Definition
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
2305 OLEANDER BLVD, Fort Pierce, FL 34982
Open in Google Maps ↗

Other Identifiers 1

Medicare NSC1231240001FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Molina Healthcare.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MITCHELL S BIDERMAN OD
Optometrist
2305 OLEANDER BLVD
FORT PIERCE, FL 34982
St. Lucie County (772) 465-6616
DR. SHANNON L W CLARK LEITENBAUER OD
Optometrist
2305 OLEANDER BLVD
FORT PIERCE, FL 34982
St. Lucie County (772) 465-6616
MYEYEDR. OPTOMETRY OF FLORIDA, LLC
Optometrist
2305 OLEANDER BLVD
FORT PIERCE, FL 34982
St. Lucie County (772) 465-6616

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon L Clark O D P A's NPI number?

The NPI number for Shannon L Clark O D P A is 1770767733. It was assigned to this organization in the NPPES registry on December 26, 2007.

Where is Shannon L Clark O D P A located?

Shannon L Clark O D P A is located at 2305 Oleander Blvd, Fort Pierce, FL 34982. The listed phone number is (772) 465-6616.

What is Shannon L Clark O D P A's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

What insurance does Shannon L Clark O D P A accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Shannon L Clark O D P A as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon L Clark O D P A was last updated on July 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.