Individual provider Active NPI

Ashley Jean Glivic, O.D.

  • Optometrist
  • Naples, FL
National Provider Identifier
1124451968
Registry record updated Aug 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4828 Issued in FL
Practice address
2191 21St St SW
Naples, FL 34117-4607
Phone
(239) 249-9931
NPI assigned
Aug 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 4828 FL Primary

Addresses

Primary practice location

2191 21St St SW
Naples, FL 34117-4607

Mailing address

2191 21St St SW
Naples, FL 34117-4607
Phone (239) 249-9931

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
I20141103000120 FL Practitioner - Optometry 6103047378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4828FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Eye Vision LLC Optometrist CurrentSince Sep 9, 2024 Accepting new patients
National Vision, Inc. Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 SW Pine Island Rd
Unit 102
Cape Coral, FL 33991
Phone (239) 387-5775

6891 Daniels Pkwy
Ste 140
Fort Myers, FL 33912
Phone (239) 243-8892

1725 W Mlk Blvd
Tampa, FL 33607
Phone (239) 800-1717

Organizations & group practices 3

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": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376524800000",
    "number": "1124451968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 21ST ST SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341174607",
            "telephone_number": "239-249-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 21ST ST SW",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341174607",
            "telephone_number": "239-249-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLIVIC",
        "first_name": "ASHLEY",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-15",
        "last_updated": "2013-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

Verify at the official NPI Registry.