Organization Active NPI

Joanne F. Reed, OD, PLLC

  • Optometrist
  • St Augustine, FL
National Provider Identifier
1083867758
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3043 Issued in FL
Legal business name
JOANNE F. REED, OD, PLLC
Practice address
124 Tuscan Way
Suite 104
St Augustine, FL 32092-1851
Phone
(904) 547-2691
Fax
(904) 547-2695
NPI assigned
Oct 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Authorized official

Name
Dr. Joanne Ford Reed, O.D.NPI 1700857158
Title
Optometrist
Phone
(904) 547-2691

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3043 FL Primary

Addresses

Primary practice location

124 Tuscan Way
Suite 104
St Augustine, FL 32092-1851

Mailing address

124 Tuscan Way
Suite 104
St Augustine, FL 32092-1851
Phone (904) 547-2691

Other names 1

  • Joanne F. Reed, OD,PA Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120314000293 FL Part B Supplier - Clinic/Group Practice 0648439406 Receives reassigned benefits from 3 practitioners
Practice locations: St Augustine, FL

National Provider Directory

National Provider Directory

Locations

124 Tuscan Way
Ste 104
St Augustine, FL 32092
Phone (904) 547-2691

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1083867758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 TUSCAN WAY",
            "address_2": "SUITE 104",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921851",
            "telephone_number": "904-547-2691",
            "fax_number": "904-547-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 TUSCAN WAY",
            "address_2": "SUITE 104",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921851",
            "telephone_number": "904-547-2691",
            "fax_number": "904-547-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOANNE F. REED, OD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_middle_name": "FORD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "904-547-2691",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "3043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joanne F. Reed, OD,PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.