NPIMap

Organization Active NPI

Harris Wilcox and Donovan P a

Doing business as Clay Eye Physicians and Surgeons

  • Ophthalmology Physician
  • Fleming Island, FL
National Provider Identifier
1710019435
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
HARRIS WILCOX AND DONOVAN P A
Doing business as
Clay Eye Physicians and Surgeons
Practice address
1855 Eastwest Pkwy
Fleming Island, FL 32003-6348
Phone
(904) 272-2020
Fax
(904) 272-5762
NPI assigned
Mar 9, 2007
Last updated
Nov 5, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
HARRIS, WILCOX AND DONOVAN, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 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
Administrator
Phone
(904) 272-2020

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU
Optometrist 152W00000X NU
Specialist 174400000X NU
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1855 Eastwest Pkwy
Fleming Island, FL 32003-6348

Mailing address

1855 Eastwest Pkwy
Fleming Island, FL 32003-6348
Phone (904) 272-2020

Other identifiers 1

IdentifierTypeStateIssuer
CB1273OtherFLRAILROAD MEDICARE

Other names 1

  • Clay Eye Physicians and Surgeons Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080701000167 FL Part B Supplier - Clinic/Group Practice 4981776333 Receives reassigned benefits from 27 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; St Augustine, FL; Orange Park, FL; Middleburg, FL; Fleming Island, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Clay Eye Phys Surgeon

Locations

1855 Eastwest Pkwy
Fleming Isle, FL 32003

2023 Professional Center Dr
Orange Park, FL 32073
Phone 9042722020234

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1710019435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 EASTWEST PKWY",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036348",
            "telephone_number": "904-272-2020",
            "fax_number": "904-272-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 EASTWEST PKWY",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320036348",
            "telephone_number": "904-272-2020",
            "fax_number": "904-272-5762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRIS WILCOX AND DONOVAN P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARRIS, WILCOX AND DONOVAN, P.A.",
        "enumeration_date": "2007-03-09",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-272-2020"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CB1273",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clay Eye Physicians and Surgeons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clay Eye Physicians and Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fleming Island, FL

Sources for this page

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