Active NPI
Kelly Hodson Unkrich, M.D.
- Ophthalmology Physician
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- ME126470
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| '017086000 | Medicaid | FL | |
| 003177389A | Medicaid | GA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37900 | SC | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | Accepting new patients | |
| The Nemours Foundation | Current | 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
- kunkrich62860@direct.nemours.org
- 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.
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1386658615
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Children's Hospital
- Wilmington, DE
- NPI 1467505073
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
- University of Florida Jacksonville Physicians, Inc.
- University of Florida, Jacksonville
- University of North Florida Student Medical Service
- University Opco LLC
- University Pharmacy of Jacksonville, Inc
- Unlimited Care , Inc
- Unlimited Home Care LLC
- Untouchable Joy Inc
- Zachary Loarn Upchurch, MD
- Dakota Anne Mackenzie Upp
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.