NPIMap

Organization Active NPI

Harris Wilcox and Donovan PA

  • Ophthalmology Physician
  • Middleburg, FL
National Provider Identifier
1659963205
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
HARRIS WILCOX AND DONOVAN PA
Practice address
1658 St Vincents Way Ste 250
Middleburg, FL 32068-8431
Phone
(904) 272-2020
Fax
(904) 276-4386
NPI assigned
Feb 5, 2021
Organization subpart
Yes
Parent organization
HARRIS WILCOX AND DONOVAN P AAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Authorized official

Name
Eric J King
Title
Practice Administrator
Phone
(904) 272-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1658 St Vincents Way Ste 250
Middleburg, FL 32068-8431

Mailing address

1658 St Vincents Way Ste 250
Middleburg, FL 32068-8431
Phone (904) 272-2020

Other identifiers 1

IdentifierTypeStateIssuer
CB1273OtherFLRAILROAD MEDICARE

Other names 1

  • Clay Eye Physicians & Surgeons Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clay.eye@direct.clayeye.nextgenshare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250729004762 FL DME Supplier - Physician - Ophthalmology 4981776333 Practice locations: Middleburg, FL

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Clay Eye Phys Surgeon4 organizations share this tax ID, including this one
Part of
Clay Eye Phys Surgeon

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2 Shircliff Way
Ste 120
Jacksonville, FL 32204
Phone (904) 619-2006

6207 Bennett Rd
Jacksonville, FL 32216
Phone (904) 731-4515

2 Shircliff Way
Jacksonville, FL 32204
Phone (904) 308-7411

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

1615 County Road 220
Ste 140
Orange Park, FL 32003
Phone (904) 276-2020

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612483200000",
    "number": "1659963205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 250",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688431",
            "telephone_number": "904-272-2020",
            "fax_number": "904-276-4386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1658 ST VINCENTS WAY STE 250",
            "city": "MIDDLEBURG",
            "state": "FL",
            "postal_code": "320688431",
            "telephone_number": "904-272-2020",
            "fax_number": "904-276-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS WILCOX AND DONOVAN PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARRIS WILCOX AND DONOVAN P A",
        "enumeration_date": "2021-02-05",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "904-272-2020"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB1273",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clay.eye@direct.clayeye.nextgenshare.com",
            "affiliation": "N",
            "address_1": "1658 St Vincents Way Ste 250",
            "city": "Middleburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320688431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Clay Eye Physicians & Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.