Individual provider Active NPI

Rockatonia Bradley

  • Optometrist
  • Fernandina Beach, FL
National Provider Identifier
1427346295
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5319 Issued in FL
Practice address
1523 Sadler Rd
Fernandina Beach, FL 32034-4467
Phone
(270) 277-2779
Fax
(270) 277-2779
NPI assigned
Jul 14, 2011
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1851DT KY
Optometrist 152W00000X 5319 FL Primary

Addresses

Primary practice location

1523 Sadler Rd
Fernandina Beach, FL 32034-4467

Mailing address

700 Barrington Dr
Fernandina Beach, FL 32034-0916
Phone (270) 339-6179

Other practice location 1

463867 State Road 200 Ste 4
Yulee, FL 32097-3605
Phone (904) 277-7779

Other practice location 2

1400 Commonwealth Dr.
Mayfield, KY 42066
Phone (270) 247-2417

Other identifiers 2

IdentifierTypeStateIssuer
000000725449OtherKYANTHEM
7100172600MedicaidKY

Other names 1

  • Dr. Rockatonia Batts Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180529000610 FL Practitioner - Optometry 2769651702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1553 S 8TH St
Fernandina Beach, FL 32034-3075
Phone (904) 663-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5319FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Eyecare LLC Optometrist CurrentSince Jan 13, 2018 Accepting new patients

Locations

1523 Sadler Rd
Fernandina Beach, FL 32034
Phone (904) 261-5955

1553 S 8th St
Fernandina Beach, FL 32034
Phone (904) 261-5955

463867 State Road 200
Ste 4
Yulee, FL 32097
Phone (904) 277-2779

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1310601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427346295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 BARRINGTON DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320340916",
            "telephone_number": "270-339-6179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 SADLER RD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344467",
            "telephone_number": "270-277-2779",
            "fax_number": "270-277-2779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "463867 State Road 200 Ste 4",
            "address_purpose": "LOCATION",
            "city": "Yulee",
            "state": "FL",
            "postal_code": "320973605",
            "country_code": "US",
            "telephone_number": "904-277-7779",
            "fax_number": "904-277-7779",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Commonwealth Dr.",
            "address_purpose": "LOCATION",
            "city": "Mayfield",
            "state": "KY",
            "postal_code": "42066",
            "country_code": "US",
            "telephone_number": "270-247-2417",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ROCKATONIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1851DT",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "5319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000725449",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100172600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROCKATONIA",
            "last_name": "BATTS",
            "prefix": "DR.",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.