Michael Gardner Kynn, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC3539 Issued in FL

Practice address

9041 Southside Blvd
Suite 174
Jacksonville, FL 32256-5484

Phone

(904) 519-5855

Fax

(904) 519-1165

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Ann Huynh Nguyen

  • Optometrist
  • Jacksonville, FL
  • NPI 1851806657
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Altamonte Springs, FL
  • NPI 1023164886
  NPD (past)
• National Vision, Inc.

  • Eyewear Supplier
  • Fort Meyers, FL
  • NPI 1477607521
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485216000000",
    "number": "1952494833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9041 SOUTHSIDE BLVD",
            "address_2": "SUITE 174",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565484",
            "telephone_number": "904-519-5855",
            "fax_number": "904-519-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9041 SOUTHSIDE BLVD",
            "address_2": "SUITE 174",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322565484",
            "telephone_number": "904-519-5855",
            "fax_number": "904-519-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KYNN",
        "first_name": "MICHAEL",
        "middle_name": "GARDNER",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC3539",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1240395T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "0E7371P",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1148",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0601001915",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "2013",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "R134TA518",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Kwok, NP
• Minkyung Kwon, MD
• Pearl Chu Kwong, MD PHD
• Wai P Kyaw, MBBS, MD
• Carl Walter Kyle, LMHC
• Oleksiy Kyrychenko, DO
• L & S Support Services
• L Medtrans Inc
• L'Arche Harbor House, Inc.
• L&L Divine Community Services Inc

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.