OrganizationActive
Shannon L Clark O D P a
NPI 1770767733 · Eyewear Supplier · Fort Pierce, FL
Shannon L Clark O D P a is a Eyewear Supplier organization in Fort Pierce, FL (NPI 1770767733).
Provider details
- NPI number
- 1770767733
- Entity type
- Organization
- Primary specialty
- Eyewear SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Shannon Clark Leitenbauer, President/Owner(772) 465-6616
- License
- OPC 0003067 (FL)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
2305 Oleander Blvd
Fort Pierce, FL 34982-5830
Phone: (772) 465-6616
Street-level locationGet directions
Mailing address
2305 Oleander Blvd
Fort Pierce, FL 34982-5830
Registry dates
- Enumerated
- 2007-12-26
- Last updated
- 2008-07-29
Frequently asked questions
- What is Shannon L Clark O D P a's NPI number?
- Shannon L Clark O D P a's National Provider Identifier (NPI) is 1770767733, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Shannon L Clark O D P a?
- Shannon L Clark O D P a is classified in the NPPES registry as Eyewear Supplier (Suppliers).
- Where is Shannon L Clark O D P a located?
- Shannon L Clark O D P a's practice location on file with NPPES is 2305 Oleander Blvd, Fort Pierce, FL 34982-5830.
- What is Shannon L Clark O D P a's phone number?
- The practice phone number listed in the NPPES registry for Shannon L Clark O D P a is (772) 465-6616.
- Who is the authorized official for Shannon L Clark O D P a?
- The authorized official listed on Shannon L Clark O D P a's NPPES record is Shannon Clark Leitenbauer, President/Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Shannon L Clark O D P a's NPI active?
- Yes — Shannon L Clark O D P a's NPI (1770767733) is active in the NPPES registry as of the last update on 2008-07-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.