Active NPI
Christina Beth Bowman, OD
- Optometrist
- Orange Park, FL
National Provider Identifier
1629066410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC 3780
- Practice address
- 905 Park Ave
Suite 100
Orange Park, FL 32073-4101 - Phone
- (904) 264-1206
- NPI assigned
- Oct 6, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC 3780 | FL | Primary |
Addresses
Primary practice location
905 Park Ave
Suite 100
Orange Park, FL 32073-4101
Mailing address
905 Park Ave
Suite 100
Orange Park, FL 32073-4101
Phone (904) 264-1206
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2381606 | Other | FL | UNITED HEALTHCARE |
| 620874600 | Medicaid | FL | |
| 28000 | Other | FL | BLUE CROSS BLUE SHIELD FL |
| 7609541 | Other | FL | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040305000063 | FL | Practitioner - Optometry | 5193613891 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dr Kyle D Abshire and Dr James R Hoffman PA
Practice addresses (Care Compare)
905 Park Ave
Suite 100
Orange Park, FL 32073-4110
Phone (904) 264-1206
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC 3780 | FL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Kyle D Abshire & Dr James R Hoffman PA | Optometrist | Current | Accepting new patients |
| South Florida Vision Services, Inc. | Optometrist | Past | Accepting new patients |
Locations
905 Park Ave
Ste 100
Orange Park, FL 32073
Phone (904) 264-1206
784 Blanding Blvd
Ste 100
Orange Park, FL 32065
Phone (305) 264-1206
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 and National Provider Directory roles.
-
- Corneal and Contact Management Optometrist
- Orange Park, FL
- NPI 1134241540
FL, Optometrist
-
- Optometrist
- Fort Lauderdale, FL
- NPI 1912032566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201564800000",
"number": "1629066410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 PARK AVE",
"address_2": "SUITE 100",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734101",
"telephone_number": "904-264-1206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 PARK AVE",
"address_2": "SUITE 100",
"city": "ORANGE PARK",
"state": "FL",
"postal_code": "320734101",
"telephone_number": "904-264-1206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "CHRISTINA",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-06",
"last_updated": "2008-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC 3780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "2381606",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620874600",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD FL",
"identifier": "28000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7609541",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.