Individual provider Active NPI

Elizabeth A Dow, O.D.

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1114210192
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4753 Issued in FL
Practice address
5255 Dunn Ave
Jacksonville, FL 32218-4361
Phone
(904) 757-1495
Fax
(904) 757-1497
NPI assigned
May 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4753 FL Primary

Addresses

Primary practice location

5255 Dunn Ave
Jacksonville, FL 32218-4361

Mailing address

5255 Dunn Ave
Jacksonville, FL 32218-4361
Phone (904) 757-1495

Other identifiers 1

IdentifierTypeStateIssuer
110111800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130213000296 FL Practitioner - Optometry 6709064645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jax Vision Care, PAGroup PAC ID 8426185927, 4 clinicians

Practice addresses (Care Compare)

5255 Dunn Ave
Jacksonville, FL 32218-4361
Phone (904) 757-1495

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4753FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Jax Vision Care, PA Optometrist CurrentSince Apr 26, 2021 Accepting new patients

Locations

5255 Dunn Ave
Jacksonville, FL 32218
Phone (904) 751-6211

201 N Hogan St
Ste 100
Jacksonville, FL 32202
Phone (904) 356-9431

30 Tavernier Dr
Ste C
Ponte Vedra, FL 32081
Phone (904) 356-9431

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1114210192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5255 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184361",
            "telephone_number": "904-757-1495",
            "fax_number": "904-757-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5255 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184361",
            "telephone_number": "904-757-1495",
            "fax_number": "904-757-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOW",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110111800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.