Individual provider Active NPI

Christina Beth Bowman, OD

  • Optometrist
  • Orange Park, FL
National Provider Identifier
1629066410
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 3780 Issued in FL
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

Updated by the provider on Jan 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2381606OtherFLUNITED HEALTHCARE
620874600MedicaidFL
28000OtherFLBLUE CROSS BLUE SHIELD FL
7609541OtherFLAETNA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 PAGroup PAC ID 7113815804, 6 clinicians

Practice addresses (Care Compare)

905 Park Ave
Suite 100
Orange Park, FL 32073-4110
Phone (904) 264-1206

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 3780FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Kyle D Abshire & Dr James R Hoffman PA Optometrist CurrentSince Sep 6, 2003 Accepting new patients
South Florida Vision Services, Inc. Optometrist PastSince Sep 6, 2003 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.

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

Verify at the official NPI Registry.