Individual provider Active NPI

Kimberly Hardin Quinones, O.D

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1467650515
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC4672 Issued in FL
Practice address
4871 Town Center Pkwy Ste 5
Jacksonville, FL 32246-8310
Phone
(904) 686-1386
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC4672 FL Primary

Addresses

Primary practice location

4871 Town Center Pkwy Ste 5
Jacksonville, FL 32246-8310

Mailing address

14964 Max Leggett Pkwy Ste 106
Jacksonville, FL 32218-7270
Phone (904) 686-1386

Other practice location 1

880 A1A N Ste 13
Ponte Vedra Beach, FL 32082-3228
Phone (904) 686-1386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20081003000303 AZ Practitioner - Optometry 5698843670
I20220110002554 FL Practitioner - Optometry 5698843670 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC4672FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Star Medical FL PLLC Optometrist CurrentSince Aug 23, 2023 Accepting new patients
Family Eyecare Associates of Az PLC Optometrist PastSince Jul 1, 2009 Accepting new patients

Locations

7124 Beracasa Way
Boca Raton, FL 33433
Phone (561) 750-7744

4871 Town Center Pkwy
Ste 5
Jacksonville, FL 32246
Phone (904) 686-1386

14964 Max Leggett Pkwy
Ste 106
Jacksonville, FL 32218
Phone (904) 647-5400

880 A1A N
Ste 13
Ponte Vedra Beach, FL 32082
Phone (904) 686-1386

3920 Bee Ridge Rd
Ste A-A
Sarasota, FL 34233
Phone (941) 867-7463

7501 Paragon Rd
Ste 201
Dayton, OH 45459

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1467650515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14964 MAX LEGGETT PKWY STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322187270",
            "telephone_number": "904-686-1386",
            "fax_number": "904-686-1363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4871 TOWN CENTER PKWY STE 5",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468310",
            "telephone_number": "904-686-1386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "880 A1A N Ste 13",
            "address_purpose": "LOCATION",
            "city": "Ponte Vedra Beach",
            "state": "FL",
            "postal_code": "320823228",
            "country_code": "US",
            "telephone_number": "904-686-1386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "KIMBERLY",
        "middle_name": "HARDIN",
        "name_prefix": "Mrs.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.