Amelia Eye Associates LLC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

OPC4033 Issued in FL

Legal business name

AMELIA EYE ASSOCIATES LLC

Practice address

1411 S 14TH St
Suite G
Fernandina Beach, FL 32034-3031

Phone

(904) 321-1333

Fax

(904) 277-1255

NPI assigned

Jun 16, 2014

Last updated

Sep 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gerald William Koss II, O.D.NPI 1528145257

Title

Managing Member

Phone

(904) 321-1333

Specialties & licenses 1

Addresses

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, and the practitioner matching its NPPES authorized official.

• Gerald W. Koss II, O.D.

  • Optometrist
  • Brunswick, GA
  • NPI 1528145257

  FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410480000000",
    "number": "1376957571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 S 14TH ST",
            "address_2": "SUITE G",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343031",
            "telephone_number": "904-321-1333",
            "fax_number": "904-277-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 S 14TH ST",
            "address_2": "SUITE G",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343031",
            "telephone_number": "904-321-1333",
            "fax_number": "904-277-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMELIA EYE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-09-12",
        "status": "A",
        "authorized_official_last_name": "KOSS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "904-321-1333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "FL",
            "license": "OPC4033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amelia Behavioral Wellness LLC
• Amelia Chiropractic Clinic
• Amelia Dental Group, PLLC
• Amelia Express Care, LLC
• Amelia Express Care, LLC
• Amelia Gentle Dentistry, LLC
• Amelia Institute of Cardiology and Medicine
• Amelia Internal Medicine,P.a.
• Amelia Island Anesthesia LLC
• Amelia Island Doctors of Optometry

• Corneal and Contact Management Optometrist in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Corneal and Contact Management Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; 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.