Kenneth Shealy, O.D.
NPI 1104436922 · Optometrist · Tifton, GA
Enrolled with Medicare as Practitioner - Optometry · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenneth Shealy, O.D. is a Optometrist provider in Tifton, GA (NPI 1104436922).
Provider details
- NPI number
- 1104436922
- Entity type
- Individual
- Primary specialty
- OptometristEye and Vision Services Providers
- Credential
- O.D.
- Sex
- Male
- Sole proprietor
- No
- License
- OPT003252 (GA)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
5 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
361 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 78 | $86 |
| Photography of the Retina92250 | 77 | $34 |
| Established Patient Complete Exam of Visual System92014 | 51 | $115 |
| New Patient Complete Exam of Visual System92004 | 42 | $135 |
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 34 | $121 |
| New Patient Office Or Other Outpatient Visit With Moderate Level of Medical Decision Making, If Using Time, 45 Minutes Or More99204 | 27 |
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 13 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Latanoprost | 125 | 50 |
| Erythromycin Basebrand: Erythromycin | 45 | 30 |
| Bimatoprostbrand: Lumigan | 29 | 13 |
| Brimonidine Tartrate | 25 | 11 |
| Dorzolamide Hcl/Timolol Maleatbrand: Dorzolamide-Timolol | 25 | 12 |
| Travoprost | 21 | — |
| Brimonidine Tartratebrand: Alphagan P | 19 | — |
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-08-06
- Last updated
- 2024-08-23
- Certified
- 2024-08-23
Frequently asked questions
- What is Kenneth Shealy's NPI number?
- Kenneth Shealy's National Provider Identifier (NPI) is 1104436922, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Shealy's specialty?
- Kenneth Shealy is listed in the NPPES registry with a primary specialty of Optometrist (Eye and Vision Services Providers).
- Where is Kenneth Shealy located?
- Kenneth Shealy's practice location on file with NPPES is 1803 Old Ocilla Rd, Tifton, GA 31794-1617.
- What is Kenneth Shealy's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Shealy is (229) 386-2181.
- Does Kenneth Shealy accept Medicare?
- Kenneth Shealy is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Kenneth Shealy's NPI active?
- Yes — Kenneth Shealy's NPI (1104436922) is active in the NPPES registry as of the last update on 2024-08-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.