Preston Henry Starks, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

FL2779 Issued in FL

Practice address

12100 Lem Turner Rd
Jacksonville, FL 32218

Phone

(904) 768-8811

Fax

(904) 641-8072

NPI assigned

Oct 27, 2006

Last updated

Aug 4, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Preston H. Starks Family Eyecare LLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1598068991
  NPD (past) Authorized official

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1760567531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 LANTANA LAKES COURT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32246",
            "telephone_number": "904-564-4177",
            "fax_number": "904-641-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 LEM TURNER RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-768-8811",
            "fax_number": "904-641-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARKS",
        "first_name": "PRESTON",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "FL2779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620957200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "620957201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Stark, MD
• Chanel Grace Starke, APRN
• Shaneka Starkes
• Tamyia Johnetta Starkes
• Alizay Starks, PA-C
• Ashley B Starkweather, PHARMD
• Rachel Anne Starnes, LMT
• Amanda Starr, RBT
• Jason Scott Starr, DO
• Brooke Starrett

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.