Colleen M King, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3718 Issued in FL

Practice address

201 N Hogan St Ste 100
Jacksonville, FL 32202-4203

Phone

(904) 356-9431

Fax

(904) 356-2969

NPI assigned

Jul 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Optometry

Education

New England College of Optometry, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jax Vision Care, PAGroup PAC ID 8426185927, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jax Vision Care, PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1609104637
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1121817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1629077649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N HOGAN ST STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024203",
            "telephone_number": "904-356-9431",
            "fax_number": "904-356-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N HOGAN ST STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024203",
            "telephone_number": "904-356-9431",
            "fax_number": "904-356-2969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-20",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0135179",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID INDIVIDUAL ID",
            "identifier": "620893200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "45002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "26115561",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7500506",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8700204",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adrienne Leigh Desantis King, PH.D., BCBA-D, NCSP
• Alexia King
• Antoinette Denise King, OTA
• Brandi R King, PHARMD
• Breonshay King
• Courtney Renee King, APRN (AANP)
• Fulterius King
• Glen King
• Hannah King
• Hannah King

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.

Verify at the official NPI Registry.