NPIMap

Organization Active NPI

Eye Center of North Florida, P.a.

  • Optometrist
  • Panama City Beach, FL
National Provider Identifier
1730284118
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE CENTER OF NORTH FLORIDA, P.A.
Practice address
10900 Hutchison Blvd
Panama City Beach, FL 32407-3712
Phone
(850) 234-1829
Fax
(850) 233-5493
NPI assigned
Sep 13, 2006
Last updated
Apr 20, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
EYE CENTER OF NORTH FLORIDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

Name
Ms. Kathi Nichols
Title
Office Manager
Phone
(850) 784-3937

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary
Corneal and Contact Management Optometrist 152WC0802X
Low Vision Rehabilitation Optometrist 152WL0500X
Pediatric Optometrist 152WP0200X
Ophthalmology Physician 207W00000X

Addresses

Primary practice location

10900 Hutchison Blvd
Panama City Beach, FL 32407-3712

Mailing address

2500 Martin Luther King Jr. Blvd
Panama City, FL 32405-4412
Phone (850) 784-3937

Other identifiers 3

IdentifierTypeStateIssuer
CG6943OtherFLRAILROAD MEDICARE
45154AOtherFLBLUE CROSS & BLUE SHIELD
257952903MedicaidFL

Other names 1

  • Panama City Beach Office Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050719000831 FL Part B Supplier - Clinic/Group Practice 0042247306 Receives reassigned benefits from 8 practitioners
3 other NPIs on this enrollment
Practice locations: Chipley, FL; Panama City, FL; Panama City Beach, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Eye Center of North Florida5 organizations share this tax ID, including this one
Part of
Eye Center of North Florida

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1400 Main St
Chipley, FL 32428
Phone (850) 638-7333

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1730284118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MARTIN LUTHER KING JR. BLVD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054412",
            "telephone_number": "850-784-3937",
            "fax_number": "850-522-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10900 HUTCHISON BLVD",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324073712",
            "telephone_number": "850-234-1829",
            "fax_number": "850-233-5493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CENTER OF NORTH FLORIDA, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EYE CENTER OF NORTH FLORIDA",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "KATHI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "850-784-3937",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG6943",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "45154A",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "257952903",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panama City Beach Office",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Panama City Beach Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; 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.