Individual provider Active NPI

Christopher Charnell, OD

  • Optometrist
  • Maitland, FL
National Provider Identifier
1891752721
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC3693 Issued in FL
Practice address
2008 Lake Howell LN
Maitland, FL 32751-5202
Phone
(407) 647-3937
Fax
(321) 251-1734
NPI assigned
Apr 26, 2006
Last updated
Apr 22, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPC3693 FL Primary

Addresses

Primary practice location

2008 Lake Howell LN
Maitland, FL 32751-5202

Mailing address

2008 Lake Howell LN
Maitland, FL 32751-5202
Phone (407) 847-3937

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
I20060316000526 FL Practitioner - Optometry 7315954245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aeg Florida Professional PLLCGroup PAC ID 3870960032, 70 clinicians

Practice addresses (Care Compare)

2008 Lake Howell LN
Maitland, FL 32751-5202
Phone (407) 647-3937

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC3693FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeg Florida Professional PLLC Optometrist CurrentSince Sep 23, 2024 Accepting new patients
Lake Howell Eye Associates, LLC Optometrist CurrentSince Mar 22, 2014 Accepting new patients

Locations

4788 Hodges Blvd
Ste 205
Jacksonville, FL 32224
Phone (904) 992-9991

2008 Lake Howell Ln
Maitland, FL 32751
Phone (407) 647-3937

5330 SW College Rd
#O
Ocala, FL 34474
Phone (352) 512-0560

Organizations & group practices 2

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1891752721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2008 LAKE HOWELL LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515202",
            "telephone_number": "407-847-3937",
            "fax_number": "321-251-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2008 LAKE HOWELL LN",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327515202",
            "telephone_number": "407-647-3937",
            "fax_number": "321-251-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARNELL",
        "first_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.