Organization Active NPI

Hendrixs Eye Care, Inc.

  • Optometrist
  • Titusville, FL
National Provider Identifier
1528424439
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3713 Issued in FL
Legal business name
HENDRIXS EYE CARE, INC.
Practice address
1917 Knox McRae Dr
Titusville, FL 32780-5360
Phone
(321) 383-1332
Fax
(321) 383-1243
NPI assigned
Jan 7, 2016
Last updated
Jan 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Authorized official

Name
David Hendrix, O.D.NPI 1750322871
Title
Owner
Phone
(321) 383-1332

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 OPC3713 FL Primary

Addresses

Primary practice location

1917 Knox McRae Dr
Titusville, FL 32780-5360

Mailing address

1917 Knox McRae Dr
Titusville, FL 32780-5360
Phone (321) 383-1332

Other identifiers 4

IdentifierTypeStateIssuer
20033OtherFLBLUE CROSS
11380258OtherFLCAQH
OPC3713OtherFLLICENSE
1750322871OtherFLNPI #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160209002361 FL Part B Supplier - Clinic/Group Practice 2860796091 Receives reassigned benefits from 5 practitioners
Practice locations: Titusville, FL; Cocoa Beach, FL

National Provider Directory

National Provider Directory

Locations

5505 N Atlantic Ave
Ste 105
Cocoa Beach, FL 32931
Phone (321) 383-1332

Practitioners & affiliated clinicians

Practitioners 5

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": "1452124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452124800000",
    "number": "1528424439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 KNOX MCRAE DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805360",
            "telephone_number": "321-383-1332",
            "fax_number": "321-383-1243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1917 KNOX MCRAE DR",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327805360",
            "telephone_number": "321-383-1332",
            "fax_number": "321-383-1243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDRIXS EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-07",
        "last_updated": "2016-01-07",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-383-1332",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20033",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11380258",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OPC3713",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI #",
            "identifier": "1750322871",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; 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.