Individual provider Active NPI

Natalie Ann Knabb, O.D

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1215247390
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4621 Issued in FL
Practice address
4890 Big Island Dr Ste 1
Jacksonville, FL 32246-7490
Phone
(904) 642-5658
Fax
(904) 564-2646
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4621 FL Primary

Addresses

Primary practice location

4890 Big Island Dr Ste 1
Jacksonville, FL 32246-7490

Mailing address

480 S 1St St
Macclenny, FL 32063-2543
Phone (858) 705-0092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4621FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace B Dorado-Foster Doctor of Optometry Professional Association Optometrist CurrentSince Dec 12, 2021 Accepting new patients
Visionworks, Inc PastSince Nov 9, 2021 Accepting new patients

Locations

4890 Big Island Dr
Ste 1
Jacksonville, FL 32246
Phone (904) 379-1260

Organizations & group practices 2

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": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1215247390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 S 1ST ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632543",
            "telephone_number": "858-705-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4890 BIG ISLAND DR STE 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467490",
            "telephone_number": "904-642-5658",
            "fax_number": "904-564-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNABB",
        "first_name": "NATALIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.