Active NPI
Michael Ernst
- Optician
- Jacksonville, FL
National Provider Identifier
1508558438
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DO6456
- Practice address
- 6830 Normandy Blvd
Jacksonville, FL 32205-1902 - Phone
- (904) 786-2234
- Fax
- (904) 786-2242
- NPI assigned
- May 22, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | DO6456 | FL | Primary |
Addresses
Primary practice location
6830 Normandy Blvd
Jacksonville, FL 32205-1902
Mailing address
676 Southland LN
Orange Park, FL 32065-2283
Phone (904) 536-3187
Other practice location 1
6767 103rd St
Jacksonville, FL 32210-7135
Phone (904) 772-6669
Other practice location 2
7075 Collins Rd
Jacksonville, FL 32244-5041
Phone (904) 365-2549
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 |
|---|---|---|---|
| DO6456 | FL | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684713600000",
"number": "1508558438",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "676 SOUTHLAND LN",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320652283",
"telephone_number": "904-536-3187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6830 NORMANDY BLVD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322051902",
"telephone_number": "904-786-2234",
"fax_number": "904-786-2242"
}
],
"practiceLocations": [
{
"address_1": "6767 103rd St",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322107135",
"country_code": "US",
"telephone_number": "904-772-6669",
"fax_number": "904-772-6277",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7075 Collins Rd",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "322445041",
"country_code": "US",
"telephone_number": "904-365-2549",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ERNST",
"first_name": "MICHAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-22",
"last_updated": "2023-05-22",
"certification_date": "2023-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "FL",
"license": "DO6456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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 May 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.