Eye-Style Optical

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO3668 Issued in FL

Legal business name

EYE-STYLE OPTICAL

Practice address

7 Old Kings Rd N Ste 32
Palm Coast, FL 32137-8247

Phone

(386) 446-4210

Fax

(386) 445-7309

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Jade Jackson, L.D.ONPI 1679630842

Title

Owner

Phone

(386) 446-4210

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Jade Jackson, L.D.O

  • Optician
  • Palm Coast, FL
  • NPI 1679630842
  NPD (past) Authorized official
• Jeremy Jackson

  • Optician
  • Palm Coast, FL
  • NPI 1518568971
  NPD
• Bonnie Marie Chalker, O.D.

  • Optometrist
  • Palm Coast, FL
  • NPI 1316998529
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699826552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 OLD KINGS RD N STE 32",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378247",
            "telephone_number": "386-446-4210",
            "fax_number": "386-445-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 OLD KINGS RD N STE 32",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321378247",
            "telephone_number": "386-446-4210",
            "fax_number": "386-445-7309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE-STYLE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JADE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-446-4210",
        "authorized_official_credential": "L.D.O"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO3668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED PROVIDER ID#",
            "identifier": "OP0463",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Estrada, DMD
• Mary Ethridge
• Ricot Etienne
• David Evans
• Extended Family of North Florida, LLC
• Eyewear Center of Flagler County Inc.
• F R Fruehan Family Practice Inc
• Richard Fabian, M.D.
• Arcangelo Faiella
• Faithangel Corp

• Optician in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Optician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.