Active NPI
Robert Keith Amiel, OD
- Optometrist
- Ft Walton Beach, FL
National Provider Identifier
1356409221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC874
- Practice address
- 36 NE Eglin Parkway
Ft Walton Beach, FL 32548 - Phone
- (850) 243-3111
- Fax
- (850) 244-8633
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC874 | FL | Primary |
Addresses
Primary practice location
36 NE Eglin Parkway
Ft Walton Beach, FL 32548
Mailing address
36 NE Eglin Parkway
Ft Walton Beach, FL 32548
Phone (850) 243-3111
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19461Z | Other | FL | MEDICARE |
| 19461 | Other | FL | BCBS |
| 078299300 | Medicaid | FL |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286755200000",
"number": "1356409221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 NE EGLIN PARKWAY",
"city": "FT WALTON BEACH",
"state": "FL",
"postal_code": "32548",
"telephone_number": "850-243-3111",
"fax_number": "850-244-8633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 NE EGLIN PARKWAY",
"city": "FT WALTON BEACH",
"state": "FL",
"postal_code": "32548",
"telephone_number": "850-243-3111",
"fax_number": "850-244-8633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMIEL",
"first_name": "ROBERT",
"middle_name": "KEITH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2010-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC874",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "19461Z",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "19461",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "078299300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.