NPI age
5 years
Enumerated 2020-08-06
● Active
Type 1 · Individual
Kenneth Trevor Shealy, O.D.
Shealy is 1 of 8 optometrist providers in Tifton and 1 of 2375 in Georgia.
Primary specialty
Optometrist
Licensed in
GA
1 state
Status
Active
No deactivations on record
Last NPPES update
2024-08-23
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 2375 active optometrist providers in Georgia.
NPI age
5 years
↓ 11 yr below median (16 yr)
State licenses
1 state
9% of peers hold multiple states
Subspecialties
0
15% of peers hold subspecialties
NPI lifetime · 2020 → 2026
2020-08Enumerated in NPPES
2020
2026
Where they practice
Practice location
1803 Old Ocilla Rd
Tifton, GA 317941617
Mailing address
1803 Old Ocilla Rd
Tifton, GA 317941617
Specialties
-
Optometrist PrimaryDoctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | OPT003252 | OPTOMETRY LICENSE |
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
Recently enumerated nearby: 1 new optometrist provider has been added in Tifton in the last 180 days.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.