Individual provider Active NPI

Rachel A Coulter, O.D.

  • Optometrist
  • Davie, FL
National Provider Identifier
1760556609
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC2627 Issued in FL
Practice address
3200 S University Dr
Nsu the Eye Institute Suite 1402
Davie, FL 33328-2018
Phone
(954) 262-1408
Fax
(954) 262-1818
NPI assigned
Nov 20, 2006
Last updated
Mar 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC2627 FL Primary

Addresses

Primary practice location

3200 S University Dr
Nsu the Eye Institute Suite 1402
Davie, FL 33328-2018

Mailing address

3850 N 31St Ter
Hollywood, FL 33021-2611
Phone (954) 961-0589

Other identifiers 1

IdentifierTypeStateIssuer
078930500MedicaidFL

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
I20041013000245 FL Practitioner - Optometry 2062472202 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC2627FLMDOptometrist
2627FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc Optometrist CurrentSince Aug 24, 2019 Accepting new patients
Nova Southeastern University, Inc Optometrist Current Accepting new patients
Nova Southeastern University Inc. CurrentSince Aug 24, 2019 Accepting new patients
Nova Southeastern University, Inc Past Accepting new patients

Locations

3200 S University Dr
Bldg 2ND
Davie, FL 33328
Phone (954) 262-4200

3200 S University Dr
Bldg 3RD
Davie, FL 33328

3200 S University Dr
Ste 1402
Davie, FL 33328
Phone (954) 262-1402

1111 W Broward Blvd
Fl 2
Fort Lauderdale, FL 33312
Phone (954) 262-4282

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

16855 NE 2nd Ave
Ste 4
North Miami Beach, FL 33162

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

5901 Del Lago Cir
Sunrise, FL 33313
Phone 9544634217 ext. 122

819 NE 26th St
Wilton Manors, FL 33305
Phone (954) 390-7654

Networks

  • Freedom Health HMO Network

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552953600000",
    "number": "1760556609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 N 31ST TER",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330212611",
            "telephone_number": "954-961-0589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 S UNIVERSITY DR",
            "address_2": "NSU THE EYE INSTITUTE SUITE 1402",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333282018",
            "telephone_number": "954-262-1408",
            "fax_number": "954-262-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "RACHEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078930500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.