Organization Active NPI

Eyeq Optometry, PLLC

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1497300800
Registry record updated Aug 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYEQ OPTOMETRY, PLLC
Practice address
4216 Herschel St
Jacksonville, FL 32210-2208
Phone
(904) 903-9413
NPI assigned
Aug 4, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2019

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

Authorized official

Name
Dr. Ashley Michelle Stowe, ODNPI 1427443225
Title
Owner/Optometrist
Phone
(904) 903-9413

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

4216 Herschel St
Jacksonville, FL 32210-2208

Mailing address

4243 Woodmere St
Jacksonville, FL 32210-2140

Other names 1

  • EyeQ Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL eyeqjax.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190918001041 FL Part B Supplier - Clinic/Group Practice 9638409675 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

4216 Herschel St
Jacksonville, FL 32210
Phone (904) 479-2020

Practitioners & affiliated clinicians

Practitioners 2

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": "1564876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564876800000",
    "number": "1497300800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4243 WOODMERE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 HERSCHEL ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322102208",
            "telephone_number": "904-903-9413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEQ OPTOMETRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-04",
        "last_updated": "2019-08-04",
        "status": "A",
        "authorized_official_last_name": "STOWE",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "904-903-9413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "eyeqjax.com",
            "affiliation": "N",
            "address_1": "4216 Herschel St",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322102208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EyeQ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.