River City Vision Center PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC 4196 Issued in FL

Legal business name

RIVER CITY VISION CENTER PA

Practice address

13453 N Main St Ste 203
Jacksonville, FL 32218-2773

Phone

(904) 696-2027

Fax

(904) 696-2028

NPI assigned

Sep 21, 2009

Last updated

Feb 16, 2024By 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, ODNPI 1720179997

Title

President

Phone

(334) 467-9776

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 4

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.

• Chandra M Williams, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1720179997
  Medicare reassignment Care Compare group NPD Authorized official
• Stephanie L Johnson, O.D.

  • Optometrist
  • Yulee, FL
  • NPI 1467673814
  Medicare reassignment Care Compare group NPD
• Adele Debra Paul, O.D.

  • Optometrist
  • Jacksonville, FL
  • NPI 1245266428
  Medicare reassignment Care Compare group NPD
• Kristen Purdy, OD

  • Optometrist
  • Brunswick, GA
  • NPI 1700497286

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1649504804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182773",
            "telephone_number": "904-696-2027",
            "fax_number": "904-696-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 203",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182773",
            "telephone_number": "904-696-2027",
            "fax_number": "904-696-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY VISION CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "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": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4052",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• River City Medical Associates, Inc (River City Pain Physicians)
• River City Nephrology PLLC
• River City Pediatric Dentistry, P.a.
• River City Physical Therapy
• River City Professional Services, Inc. (River City Home Health)
• River Garden Hebrew Home for the Aged
• River Garden Hebrew Home for the Aged
• River Hills Chiropractic Clinic Inc
• River Oaks Dental
• River Region Human Services

• 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 16, 2024; 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.