Individual provider Active NPI

Ann Huynh-Nguyen, O.D.

  • Optometrist
  • Jacksonville, FL
National Provider Identifier
1841314739
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 4447 Issued in FL
Practice address
9041 Southside Blvd Ste a
Target Optical
Jacksonville, FL 32256-5484
Phone
(904) 519-5057
Fax
(904) 519-2833
NPI assigned
Mar 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 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 OPC 4447 FL Primary

Addresses

Primary practice location

9041 Southside Blvd Ste a
Target Optical
Jacksonville, FL 32256-5484

Mailing address

1334 N Kyle Way
Saint Johns, FL 32259-1927
Phone (832) 754-8310

Other practice location 1

6100 Greenland Rd Ste 604
Jacksonville, FL 32258-2453
Phone (904) 280-4855

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
I20221003000052 FL Practitioner - Optometry 6305222191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6100 Greenland Rd
Suite 604
Jacksonville, FL 32258-2453
Phone (904) 280-4855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 4447FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Huynh Nguyen Optometrist Current Accepting new patients
Ann Huynh Nguyen OD LLC Optometrist CurrentSince Nov 1, 2022 Accepting new patients
Champion Eye Inc PastSince Feb 25, 2021 Accepting new patients

Locations

6100 Greenland Rd
Ste 604
Jacksonville, FL 32258
Phone (904) 280-4855

13740 Beach Blvd
Jacksonville, FL 32224
Phone (904) 207-7077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1841314739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 N KYLE WAY",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591927",
            "telephone_number": "832-754-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 SOUTHSIDE BLVD STE A",
            "address_2": "TARGET OPTICAL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565484",
            "telephone_number": "904-519-5057",
            "fax_number": "904-519-2833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6100 Greenland Rd Ste 604",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322582453",
            "country_code": "US",
            "telephone_number": "904-280-4855",
            "fax_number": "904-280-4853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUYNH-NGUYEN",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 4447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.