Lake City Eye Physicians, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0700004320 Issued in FL

Legal business name

LAKE CITY EYE PHYSICIANS, LLC

Practice address

621 SW Baya Dr
Suite 101
Lake City, FL 32025-4240

Phone

(386) 754-6616

Fax

(386) 754-6615

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Reaves C Cloe, O.D.

Title

Owner

Phone

(386) 754-6616

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.

• Reaves C Cole, O.D.

  • Optometrist
  • Lake City, FL
  • NPI 1407956071
  Medicare reassignment

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235350208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 SW BAYA DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320254240",
            "telephone_number": "386-754-6616",
            "fax_number": "386-754-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 SW BAYA DR",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320254240",
            "telephone_number": "386-754-6616",
            "fax_number": "386-754-6615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CITY EYE PHYSICIANS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CLOE",
        "authorized_official_first_name": "REAVES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-754-6616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "0700004320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "19899",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CHI Kwong Lai, MD
• Lake City Cancer Care LLC
• Lake City Cancer Care LLC (Cancer Care of North Florida & Urology Medical of North Florida)
• Lake City Chiropractic and Massage
• Lake City Dental
• Lake City FL Opco LLC
• Lake City Home Medical Equipment, Inc.
• Lake City Imaging LLC (Invision Imaging Center at Lake City)
• Lake City Medical Center Emergency Physicians, LLC
• Lake City MGT LLC (Avalon Healthcare Center)

• Optometrist in Lake City, FL
• Providers in Lake City, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.