Congleton Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

CONGLETON EYE CARE, LLC

Practice address

4600 Mobile Hwy
Suite 122
Pensacola, FL 32506

Phone

(850) 455-0722

Fax

(850) 455-0723

NPI assigned

Jun 9, 2015

Last updated

Sep 25, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jamie Congleton, O.D.NPI 1578945705

Title

President

Phone

(850) 455-0722

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

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.

• Jamie Congleton, O.D.

  • Optometrist
  • Pensacola, FL
  • NPI 1578945705
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1750761375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 MOBILE HWY #9",
            "address_2": "PMB 139",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32506",
            "telephone_number": "850-455-0722",
            "fax_number": "850-455-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 MOBILE HWY",
            "address_2": "SUITE 122",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "32506",
            "telephone_number": "850-455-0722",
            "fax_number": "850-455-0723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGLETON EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "CONGLETON",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-455-0722",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "IG569A",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICARE - INDIVIDUAL PTAN",
            "identifier": "IG570Z",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Concura Inc. (CareMinders Home Care)
• Edward G Condon III, CRNA
• Jamie Williams Condon, ND
• Lisa Cone, OTR/L
• Peter Joseph Congiundi, DDS
• Jamie Congleton, O.D.
• Jeanette L Connell, DNP, ACNP-BC, FNP-C
• Austin Paul Conner Sr., R.PH
• Kayla Connick, MT-BC
• Megan Leeanne Conrad

• Optometrist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.