First Coast Vision Care PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

4196 Issued in FL

Legal business name

FIRST COAST VISION CARE PA

Practice address

12100 Lem Turner Rd
Jacksonville, FL 32218-2304

Phone

(904) 764-3801

Fax

(904) 764-3761

NPI assigned

Jan 29, 2018

Last updated

Nov 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chandra M Williams, O.D.

Title

President

Phone

(334) 467-9776

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1639677214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 EAGLE LANDING PKWY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320652634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 LEM TURNER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182304",
            "telephone_number": "904-764-3801",
            "fax_number": "904-764-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST VISION CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "CHANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-467-9776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.