Active NPI
John S Geddes III, O.D.
- Optometrist
- Summerfield, FL
National Provider Identifier
1952339921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2954
- Practice address
- 10250 SE 167TH Place Rd
Suite 4
Summerfield, FL 34491-8686 - Phone
- (352) 693-2545
- Fax
- (352) 693-2449
- NPI assigned
- Jun 29, 2006
- Last updated
- Feb 5, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2954 | FL | Primary |
Addresses
Primary practice location
10250 SE 167TH Place Rd
Suite 4
Summerfield, FL 34491-8686
Mailing address
1508 Texas CT
Tavares, FL 32778-2130
Phone (352) 360-0306
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 620130000 | Medicaid | FL |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Southern College of Optometry, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5607 Johns Rd
Tampa, FL 33634-4499
Phone (813) 385-1873
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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.
-
- Optometrist
- Orlando, FL
- NPI 1164308771
-
- Optometrist
- Summerfield, FL
- NPI 1548406473
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580860800000",
"number": "1952339921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1508 TEXAS CT",
"city": "TAVARES",
"state": "FL",
"postal_code": "327782130",
"telephone_number": "352-360-0306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10250 SE 167TH PLACE RD",
"address_2": "SUITE 4",
"city": "SUMMERFIELD",
"state": "FL",
"postal_code": "344918686",
"telephone_number": "352-693-2545",
"fax_number": "352-693-2449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDDES",
"first_name": "JOHN",
"middle_name": "S",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2020-02-05",
"certification_date": "2020-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "2954",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "620130000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Summerfield, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.