Individual provider Active NPI

Kelly Hodson Unkrich, M.D.

  • Ophthalmology Physician
  • Jacksonville, FL
National Provider Identifier
1902199508
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
ME126470 Issued in FL
Practice address
807 Childrens Way
Nemours Childrens Clinic, Jacksonville
Jacksonville, FL 32207
Phone
(904) 697-3694
Fax
(302) 651-4945
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 37900 SC
Ophthalmology Physician 207W00000X ME126470 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

807 Childrens Way
Nemours Childrens Clinic, Jacksonville
Jacksonville, FL 32207

Mailing address

PO Box 191
Provider Enrollment Department
Rockland, DE 19732-0191
Phone (302) 651-6212

Other identifiers 2

IdentifierTypeStateIssuer
'017086000MedicaidFL
003177389AMedicaidGA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161207001101 FL Practitioner - Ophthalmology 7012224801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37900SCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation CurrentSince Oct 1, 2016 Accepting new patients
The Nemours Foundation Current Accepting new patients
The Nemours Foundation CurrentSince Oct 1, 2016 Accepting new patients

Locations

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

6535 Nemours Pkwy
Orlando, FL 32827
Phone (407) 567-4000

8331 N Davis Hwy
Spc Care
Pensacola, FL 32514
Phone (850) 505-4700

Interoperability endpoints

  • Direct secure messaging: kunkrich62860@direct.nemours.org
  • Direct secure messaging: kunkrich223213@direct.shands.ufl.edu

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481155200000",
    "number": "1902199508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPARTMENT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 CHILDRENS WAY",
            "address_2": "NEMOURS CHILDRENS CLINIC, JACKSONVILLE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-697-3694",
            "fax_number": "302-651-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNKRICH",
        "first_name": "KELLY",
        "middle_name": "HODSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2016-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "37900",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME126470",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "'017086000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003177389A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.