Individual provider Active NPI

Joanne Ford Reed, OD

  • Optometrist
  • St Augustine, FL
National Provider Identifier
1700857158
Registry record updated Mar 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC003043 Issued in FL
Practice address
124 Tuscan Way
Ste 104
St Augustine, FL 32092-1851
Phone
(904) 547-2691
Fax
(904) 547-2695
NPI assigned
Feb 1, 2006
Last updated
Mar 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC003043 FL Primary

Addresses

Primary practice location

124 Tuscan Way
Ste 104
St Augustine, FL 32092-1851

Mailing address

124 Tuscan Way
Suite 104
St Augustine, FL 32092-1851
Phone (904) 547-2691

Other identifiers 2

IdentifierTypeStateIssuer
20773OtherFLBCBS
62089500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040310000784 FL Practitioner - Optometry 2163310087 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joanne F. Reed, OD,PAGroup PAC ID 0648439406, 3 clinicians

Practice addresses (Care Compare)

124 Tuscan Way
Suite 104
St Augustine, FL 32092-1851
Phone (904) 547-2691

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC003043FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Joanne F. Reed, OD, PLLC Optometrist CurrentSince Oct 27, 2011 Accepting new patients
DRS. Barrack & Liane,PA Optometrist Past Accepting new patients
Brian S Armitage, O.D., P.a. Past Accepting new patients
Dortheanne J. Roberts, OD PA Optometrist Past Accepting new patients

Locations

124 Tuscan Way
Ste 104
St Augustine, FL 32092
Phone (904) 547-2691

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1700857158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 TUSCAN WAY",
            "address_2": "SUITE 104",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921851",
            "telephone_number": "904-547-2691",
            "fax_number": "904-547-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 TUSCAN WAY",
            "address_2": "STE 104",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320921851",
            "telephone_number": "904-547-2691",
            "fax_number": "904-547-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REED",
        "first_name": "JOANNE",
        "middle_name": "FORD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC003043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "20773",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "62089500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.