Organization Active NPI

Okaloosa Eye Care PA

  • Optometrist
  • Crestview, FL
National Provider Identifier
1124160395
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OKALOOSA EYE CARE PA
Practice address
207 N Main St
Crestview, FL 32536-3543
Phone
(850) 683-0221
Fax
(850) 683-0225
NPI assigned
Feb 13, 2007
Last updated
Aug 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Authorized official

Name
Dr. Chelsea Rayna Evans, O.D.NPI 1477939478
Title
President
Phone
(850) 683-0221

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 Primary

Addresses

Primary practice location

207 N Main St
Crestview, FL 32536-3543

Mailing address

207 N Main St
Crestview, FL 32536-3543
Phone (850) 683-0221

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051208000258 FL Part B Supplier - Clinic/Group Practice 0840211645 Receives reassigned benefits from 3 practitioners
Practice locations: Crestview, FL
O20100930090907 FL DME Supplier - Physician - Optometrist 0840211645 Practice locations: Crestview, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Okaloosa Eye Care PA207 N Main St, Crestview, FL 32536-3543(850) 683-0221 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since May 16, 2005

National Provider Directory

National Provider Directory

Locations

207 N Main St
Crestview, FL 32536
Phone (850) 683-0221

Interoperability endpoints

  • Direct secure messaging: ariggs@okaloosaeyecare.eyefinity-direct.com
  • Direct secure messaging: dr.batson@okaloosaeyecare.eyefinity-direct.com
  • Direct secure messaging: dr.evans@okaloosaeyecare.eyefinity-direct.com
  • Direct secure messaging: dr.purdy@okaloosaeyecare.eyefinity-direct.com
  • Direct secure messaging: dr.robby@okaloosaeyecare.eyefinity-direct.com

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1124160395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363543",
            "telephone_number": "850-683-0221",
            "fax_number": "850-683-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N MAIN ST",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325363543",
            "telephone_number": "850-683-0221",
            "fax_number": "850-683-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKALOOSA EYE CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "CHELSEA",
        "authorized_official_middle_name": "RAYNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-683-0221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.