Individual provider Active NPI

Alison Suzanne McMinn, DO 5713

  • Optician
  • Jacksonville, FL
National Provider Identifier
1407548340
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO5713 Issued in FL
Practice address
300 Busch Dr
Jacksonville, FL 32218-5551
Phone
(904) 757-3886
Fax
(904) 757-9771
NPI assigned
May 22, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X SINGLE SPECIALTY GROUP 156FX1800X DO5713 FL Primary

Addresses

Primary practice location

300 Busch Dr
Jacksonville, FL 32218-5551

Mailing address

300 Busch Dr
Jacksonville, FL 32218-5551
Phone (904) 757-3886

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
DO5713FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1407548340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BUSCH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185551",
            "telephone_number": "904-757-3886",
            "fax_number": "904-757-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BUSCH DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322185551",
            "telephone_number": "904-757-3886",
            "fax_number": "904-757-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMINN",
        "first_name": "ALISON",
        "middle_name": "SUZANNE",
        "credential": "DO  5713",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO5713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

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