James Revennaugh, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4450 Issued in FL

Practice address

86 Ponce de Leon Blvd
Brooksville, FL 34601-2818

Phone

(352) 796-2141

NPI assigned

Aug 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
• Direct secure messaging: james.revennaugh.p1@direct.tec.nextgenshare.com

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.

• Coppedge Eyecare, LLC

  • Optometrist
  • Brooksville, FL
  • NPI 1568690238
  Medicare reassignment
• Tampa Eye Clinic and Associates PA

  • Ophthalmology Physician
  • Tampa, FL
  • NPI 1013937861
  NPD
• Coppedge and Wooster PA

  • Optometrist
  • Brooksville, FL
  • NPI 1497923122
  NPD (past)

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1124251905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14073 SNOW MEMORIAL HWY",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346014466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 PONCE DE LEON BLVD",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346012818",
            "telephone_number": "352-796-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REVENNAUGH",
        "first_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-27",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Alejandra Renderos, APRN
• Alicia M Rendon, NP
• Eric J Renker, CRPH
• Brent Rentfro, P.A.
• Restorative Mind LLC
• Greydis Reyes Lopez
• Katherine Marie Reyes, MD
• Cornelia J Reynolds, LMHC
• Jason William Reynolds, MD
• Kobra Rezaei, APRN

• Optometrist in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.