Riverside Eye and Laser Specialists, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

RIVERSIDE EYE AND LASER SPECIALISTS, P.A.

Practice address

1034 Riverside Ave
Jacksonville, FL 32204-4123

Phone

(904) 354-2114

Fax

(904) 354-2122

NPI assigned

Sep 19, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Brittany R. Agee, M.D.NPI 1760771851

Title

Owner

Phone

(904) 355-1525

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Brittany Ransom Agee, M.D.

  • Ophthalmology Physician
  • Jacksonville, FL
  • NPI 1760771851
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537315200000",
    "number": "1154805760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044123",
            "telephone_number": "904-354-2114",
            "fax_number": "904-354-2122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044123",
            "telephone_number": "904-354-2114",
            "fax_number": "904-354-2122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE EYE AND LASER SPECIALISTS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A",
        "authorized_official_last_name": "AGEE",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-355-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "151LL",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcal Ayana Rivers
• Marlo M Rivers, PT
• Stanley Rivers
• Riverside Anesthesia Services, LLC
• Riverside Endoscopy Center LLC
• Riverside Kingsley Endoscopy Surgicenter, LLC (Riverside Endoscopy Center)
• Riverside Medical Diagnostic and Imaging, LLC
• Riverside Operator LLC (Riverside Post Acute)
• Riverside Park Surgicenter LLC
• Riverside Spine & Pain Physicians, LLC

• Specialist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.