Active NPI
Lawrence Alan Carroll, OPTICIAN
- Optician
- Palatka, FL
National Provider Identifier
1487772935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO889
- Practice address
- 3710 Saint Johns Ave
Palatka, FL 32177-4026 - Phone
- (386) 328-2020
- Fax
- (386) 328-6430
- NPI assigned
- Mar 26, 2007
- Last updated
- Jan 23, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DO889 | FL | Primary |
Addresses
Primary practice location
3710 Saint Johns Ave
Palatka, FL 32177-4026
Mailing address
3710 Saint Johns Ave
Palatka, FL 32177-4026
Phone (386) 328-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| DO889 | FL | MD | Optician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gregory Kipp O.D. | Past | Accepting new patients | |
| Optical Shop of Palatka Inc | Optician | Past | Accepting new patients |
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.
-
- Optometrist
- Palatka, FL
- NPI 1336411891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1487772935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3710 SAINT JOHNS AVE",
"city": "PALATKA",
"state": "FL",
"postal_code": "321774026",
"telephone_number": "386-328-2020",
"fax_number": "386-328-6430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SAINT JOHNS AVE",
"city": "PALATKA",
"state": "FL",
"postal_code": "321774026",
"telephone_number": "386-328-2020",
"fax_number": "386-328-6430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARROLL",
"first_name": "LAWRENCE",
"middle_name": "ALAN",
"credential": "OPTICIAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO889",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palatka, FL
- Canaday and Jagedo Physician Associates PL
- Narsimha Candula
- Cardiac Care Center Inc
- Francis Carmel, MSN, FNP-BC
- Shannon Terry Carrigan, RD/LD ,MS
- Brenda R Castells, MD
- Michelle Lee Casto, ARNP
- Lucia F Castro, LPN
- Centers for Advanced Imaging Inc
- Centerwell Health Services (Certified), Inc. (Centerwell Home Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.