NPIMap

Organization Active NPI

Fleming Island Vision Center, Inc.

Doing business as Pearle Vision of Fleming Island

  • Optometrist
  • Fleming Island, FL
National Provider Identifier
1245482710
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3085 Issued in FL
Legal business name
FLEMING ISLAND VISION CENTER, INC.
Doing business as
Pearle Vision of Fleming Island
Practice address
1524 County Road 220 Ste 5
Fleming Island, FL 32003-4913
Phone
(904) 637-2000
Fax
(904) 637-2001
NPI assigned
Oct 16, 2008
Last updated
Dec 14, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Dr. Jeffrey Scott Blalock, O.D.NPI 1356434237
Title
Optometrist
Phone
(904) 637-2000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC 3085 FL Primary

Addresses

Primary practice location

1524 County Road 220 Ste 5
Fleming Island, FL 32003-4913

Mailing address

1524 County Road 220 Ste 5
Fleming Island, FL 32003-4913
Phone (904) 637-2000

Other names 1

  • Pearle Vision of Fleming Island Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091221000557 FL Part B Supplier - Clinic/Group Practice 9638219793 Receives reassigned benefits from 10 practitioners
Practice locations: Fleming Island, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1245482710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 COUNTY ROAD 220 STE 5",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034913",
            "telephone_number": "904-637-2000",
            "fax_number": "904-637-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 COUNTY ROAD 220 STE 5",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034913",
            "telephone_number": "904-637-2000",
            "fax_number": "904-637-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING ISLAND VISION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "BLALOCK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "904-637-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 3085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision of Fleming Island",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.