Individual provider Active NPI

Kimberly Ann Spiczka, LDO

  • Optician
  • Port Richey, FL
National Provider Identifier
1275225328
Registry record updated May 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO7884 Issued in FL
Practice address
8701 US Highway 19
Port Richey, FL 34668-5349
Phone
(727) 848-9571
Fax
(727) 848-5780
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO7884 FL Primary

Addresses

Primary practice location

8701 US Highway 19
Port Richey, FL 34668-5349

Mailing address

8114 Sylvan Dr
Hudson, FL 34667-1443
Phone (309) 267-3985

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO7884FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1275225328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8114 SYLVAN DR",
            "city": "HUDSON",
            "state": "FL",
            "postal_code": "346671443",
            "telephone_number": "309-267-3985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 US HIGHWAY 19",
            "city": "PORT RICHEY",
            "state": "FL",
            "postal_code": "346685349",
            "telephone_number": "727-848-9571",
            "fax_number": "727-848-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPICZKA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LDO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO7884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.