Individual provider Active NPI

James Anthony Horning, OD OPTOMETRIST

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1710063086
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC001749 Issued in FL
Practice address
4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224-7223
Phone
(904) 992-9991
Fax
(904) 246-0269
NPI assigned
Oct 30, 2006
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC001749 FL Primary

Addresses

Primary practice location

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224-7223

Mailing address

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224-7223
Phone (904) 992-9991

Other practice location 1

1100 S Ponce De Leon Blvd
Ste 4
St Augustine, FL 32084-6013
Phone (904) 824-0212

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
I20080312000215 FL Practitioner - Optometry 8224113493 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC001749FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Florida Professional PLLC Optometrist CurrentSince Mar 19, 2022 Accepting new patients
First Coast Hearing Clinic, Inc. PastSince Jun 1, 2017 Accepting new patients

Locations

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

Organizations & group practices 3

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": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1710063086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4788 HODGES BLVD",
            "address_2": "STE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247223",
            "telephone_number": "904-992-9991",
            "fax_number": "904-246-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4788 HODGES BLVD",
            "address_2": "STE 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247223",
            "telephone_number": "904-992-9991",
            "fax_number": "904-246-0269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Ponce De Leon Blvd",
            "address_2": "Ste 4",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320846013",
            "country_code": "US",
            "telephone_number": "904-824-0212",
            "fax_number": "904-824-0132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORNING",
        "first_name": "JAMES",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD OPTOMETRIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC001749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.