Individual provider Active NPI

Joshua Carson Woolwine, O.D.

  • Optometrist
  • Tampa, FL
National Provider Identifier
1215389754
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 5248 Issued in FL
Practice address
14901 N Dale Mabry Hwy
Tampa, FL 33618-1801
Phone
(813) 960-8318
NPI assigned
Jul 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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 5248 FL Primary

Addresses

Primary practice location

14901 N Dale Mabry Hwy
Tampa, FL 33618-1801

Mailing address

5107 Alice Rd
Tampa, FL 33624-2003

Other names 1

  • Carson Woolwine Other name

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
I20160928000010 FL Practitioner - Optometry 3375830888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Doctors Optical Outlets PAGroup PAC ID 0042123846, 97 clinicians

Practice addresses (Care Compare)

5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 5248FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Optometry, PA CurrentSince Sep 19, 2018 Accepting new patients
National Vision, Inc. Past Accepting new patients
Eye Doctors Optical Outlets, PA Optometrist Past Accepting new patients
National Vision, Inc. Past Accepting new patients

Locations

706 W State Road 436
Altamonte Springs, FL 32714
Phone (407) 774-1318

4957 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 278-1217

2411 SW College Rd
Ocala, FL 34471
Phone (352) 873-3937

10224 E Adamo Dr
Tampa, FL 33619
Phone (813) 315-9898

Organizations & group practices 5

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": "1467936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1215389754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5107 ALICE RD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336242003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14901 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181801",
            "telephone_number": "813-960-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLWINE",
        "first_name": "JOSHUA",
        "middle_name": "CARSON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-08",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 5248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARSON",
            "last_name": "WOOLWINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.