NPIMap

Organization Active NPI

Total Vision of Palm Coast Inc

  • Optometrist
  • Palm Coast, FL
National Provider Identifier
1972707958
Registry record updated Jul 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC 0002395 Issued in FL
Legal business name
TOTAL VISION OF PALM COAST INC
Practice address
15 Cypress Branch Way
Suite #205
Palm Coast, FL 32164-8413
Phone
(386) 445-1880
Fax
(386) 445-8796
NPI assigned
Jun 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2008

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

Authorized official

Name
Dr. Phillip Lee Stephens, O.D.NPI 1851476956
Title
Owner
Phone
(386) 445-1880

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC 0002395 FL Primary

Addresses

Primary practice location

15 Cypress Branch Way
Suite #205
Palm Coast, FL 32164-8413

Mailing address

15 Cypress Branch Way
Suite #205
Palm Coast, FL 32164-8413
Phone (386) 445-1880

Other identifiers 1

IdentifierTypeStateIssuer
078287400MedicaidFL

Other names 1

  • Total Vision Eye Health assoc. Doing business as

National Provider Directory

National Provider Directory

Locations

15 Cypress Branch Way
Ste 206
Palm Coast, FL 32164
Phone (386) 445-1880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216857600000",
    "number": "1972707958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CYPRESS BRANCH WAY",
            "address_2": "SUITE #205",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648413",
            "telephone_number": "386-445-1880",
            "fax_number": "386-445-8796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CYPRESS BRANCH WAY",
            "address_2": "SUITE #205",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321648413",
            "telephone_number": "386-445-1880",
            "fax_number": "386-445-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL VISION OF PALM COAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2008-07-24",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-445-1880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC 0002395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078287400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Total Vision Eye Health assoc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2008; 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.