NPIMap

Organization Active NPI

Kens United Optical

  • Eyewear Supplier
  • Orange Park, FL
National Provider Identifier
1942755160
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
DO3062 Issued in FL
Legal business name
KENS UNITED OPTICAL
Practice address
225 Blanding Blvd
Orange Park, FL 32073-3357
Phone
(904) 276-4611
NPI assigned
Aug 17, 2016
Last updated
May 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
Mr. Kenneth Lawrence Groleau, DONPI 1821452236
Title
Owner/ Dispensing Optician
Phone
(904) 276-4611

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
Eyewear Supplier 332H00000X DO3062 FL Primary

Addresses

Primary practice location

225 Blanding Blvd
Orange Park, FL 32073-3357

Mailing address

225 Blanding Blvd
Orange Park, FL 32073-3357
Phone (904) 276-4611

National Provider Directory

National Provider Directory

Locations

225 Blanding Blvd
Orange Park, FL 32073
Phone (904) 276-4611

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1942755160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 BLANDING BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733357",
            "telephone_number": "904-276-4611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BLANDING BLVD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733357",
            "telephone_number": "904-276-4611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENS UNITED OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-17",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "GROLEAU",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER/ DISPENSING OPTICIAN",
        "authorized_official_telephone_number": "904-276-4611",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "FL",
            "license": "DO3062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 11, 2017; 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.