Organization Active NPI

Ann Huynh Nguyen OD LLC

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1700505351
Registry record updated Aug 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
ANN HUYNH NGUYEN OD LLC
Practice address
6100 Greenland Rd Ste 604
Jacksonville, FL 32258-2453
Phone
(904) 280-4855
Fax
(904) 280-4853
NPI assigned
Aug 25, 2022
Last updated
Aug 25, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2022

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

Authorized official

Name
Ann Huynh Nguyen, DONPI 1841314739
Title
Owner
Phone
(904) 280-4855

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

6100 Greenland Rd Ste 604
Jacksonville, FL 32258-2453

Mailing address

1334 N Kyle Way
Saint Johns, FL 32259-1927
Phone (904) 280-4855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221003000035 FL Part B Supplier - Clinic/Group Practice 5496131286 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

6100 Greenland Rd
Ste 604
Jacksonville, FL 32258
Phone (904) 280-4855

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1661385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1700505351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 N KYLE WAY",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591927",
            "telephone_number": "904-280-4855",
            "fax_number": "904-280-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 GREENLAND RD STE 604",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582453",
            "telephone_number": "904-280-4855",
            "fax_number": "904-280-4853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN HUYNH NGUYEN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-25",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "HUYNH NGUYEN",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-280-4855",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2022; 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.