Individual provider Active NPI

James Davis IV

  • Optometrist
  • Clermont, FL
National Provider Identifier
1902987514
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 2033 Issued in FL
Practice address
730 7TH St
Clermont, FL 34711-2145
Phone
(352) 394-6168
Fax
(352) 394-6645
NPI assigned
Oct 18, 2006
Last updated
May 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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 2033 FL Primary

Addresses

Primary practice location

730 7TH St
Clermont, FL 34711-2145

Mailing address

730 7TH St
Clermont, FL 34711-2145
Phone (352) 394-6168

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
I20110407000168 FL Practitioner - Optometry 0143334953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

730 7TH St
Clermont, FL 34711-2145
Phone (352) 394-6168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPC 2033FLMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. James R. Davis, IV, O.D., Inc. Optometrist CurrentSince May 4, 2009 Accepting new patients
Seaman Healthcare Holdings, Inc. Optometrist PastSince Jul 26, 2010 Accepting new patients

Locations

730 7th St
Clermont, FL 34711
Phone (352) 394-6168

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305072000000",
    "number": "1902987514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 7TH ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112145",
            "telephone_number": "352-394-6168",
            "fax_number": "352-394-6645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 7TH ST",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347112145",
            "telephone_number": "352-394-6168",
            "fax_number": "352-394-6645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS IV",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2011-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 2033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.