NPIMap

Organization Active NPI

305 Vision

  • Optometrist
  • Pinecrest, FL
National Provider Identifier
1508419011
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
305 VISION
Practice address
9569 S Dixie Hwy
Pinecrest, FL 33156-2802
Phone
(305) 424-8451
NPI assigned
Jul 23, 2019
Last updated
Jul 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Dr. Shannon Evans, ODNPI 1205184488
Title
Ceo
Phone
(302) 670-4096

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
Optometrist 152W00000X Primary

Addresses

Primary practice location

9569 S Dixie Hwy
Pinecrest, FL 33156-2802

Mailing address

9569 S Dixie Hwy
Pinecrest, FL 33156-2802
Phone (305) 424-8451

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 305-424-8526 Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1563840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1508419011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9569 S DIXIE HWY",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331562802",
            "telephone_number": "305-424-8451",
            "fax_number": "305-424-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9569 S DIXIE HWY",
            "city": "PINECREST",
            "state": "FL",
            "postal_code": "331562802",
            "telephone_number": "305-424-8451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "305 VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-23",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "302-670-4096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "305-424-8526",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "9569 S Dixie Hwy",
            "city": "Pinecrest",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331562802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pinecrest, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; 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.