NPIMap

Organization Active NPI

Fleming Island Vision Center

Doing business as Pearle Vision

  • Optometrist
  • Orange Park, FL
National Provider Identifier
1861668964
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3085 Issued in FL
Legal business name
FLEMING ISLAND VISION CENTER
Doing business as
Pearle Vision
Practice address
1524 County Road 220 Ste 5
Orange Park, FL 32003-4913
Phone
(904) 637-2000
NPI assigned
May 8, 2008
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Dr. Theodore Melvin Brink, ODNPI 1174616155
Title
Owner
Phone
(904) 260-3839

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X OPC3085 FL Primary

Addresses

Primary practice location

1524 County Road 220 Ste 5
Orange Park, FL 32003-4913

Mailing address

11406-1 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 260-3839

Other names 1

  • Pearle Vision Doing business as

National Provider Directory

National Provider Directory

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": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1861668964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11406-1 SAN JOSE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32223",
            "telephone_number": "904-260-3839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 COUNTY ROAD 220 STE 5",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320034913",
            "telephone_number": "904-637-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLEMING ISLAND VISION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "BRINK",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "MELVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-260-3839",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.