Organization Active NPI

Dr Ted Brink & Associates

  • Optometrist
  • Orange Park, FL
National Provider Identifier
1467775312
Registry record updated Mar 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DR TED BRINK & ASSOCIATES
Practice address
1911 Wells Rd
Orange Park, FL 32073-1702
Phone
(904) 215-9700
Fax
(904) 215-9701
NPI assigned
Mar 8, 2010
Organization subpart
Yes
Parent organization
DR TED BRINK & ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 8, 2010

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

Authorized official

Name
Dr. Ted Brink
Title
President
Phone
(904) 260-3839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

1911 Wells Rd
Orange Park, FL 32073-1702

Mailing address

11406 San Jose Blvd
Jacksonville, FL 32223-7963
Phone (904) 260-3839

National Provider Directory

National Provider Directory
Part of
Dr Ted Brink Associates PA

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268006400000",
    "number": "1467775312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322237963",
            "telephone_number": "904-260-3839",
            "fax_number": "904-260-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320731702",
            "telephone_number": "904-215-9700",
            "fax_number": "904-215-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TED BRINK & ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DR TED BRINK & ASSOCIATES",
        "enumeration_date": "2010-03-08",
        "last_updated": "2010-03-08",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "TED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-260-3839",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.