Organization Active NPI

Northeast Florida Eye Care Addociates

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1003241019
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
NORTHEAST FLORIDA EYE CARE ADDOCIATES
Practice address
4413 Town Center Pkwy
Suite 207
Jacksonville, FL 32246-8568
Phone
(904) 998-9822
NPI assigned
Sep 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ryan Williams
Title
Coo
Phone
(904) 545-4465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4413 Town Center Pkwy
Suite 207
Jacksonville, FL 32246-8568

Mailing address

11406 San Jose Blvd
Suite 1
Jacksonville, FL 32223-7963
Phone (904) 260-3839

National Provider Directory

National Provider Directory
Tax ID family
Northeast Florida Eye Care Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4413 Town Center Pkwy
Ste 207
Jacksonville, FL 32246
Phone (904) 998-9822

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1003241019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406 SAN JOSE BLVD",
            "address_2": "SUITE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237963",
            "telephone_number": "904-260-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4413 TOWN CENTER PKWY",
            "address_2": "SUITE 207",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468568",
            "telephone_number": "904-998-9822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FLORIDA EYE CARE ADDOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "904-545-4465"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.