NPIMap

Organization Active NPI

McClane & Stubits OD PA

  • Optometrist
  • Fernandina Beach, FL
National Provider Identifier
1982617619
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1488 Issued in FL
Legal business name
MCCLANE & STUBITS OD PA
Practice address
6 S 14TH St
Fernandina Beach, FL 32034-3212
Phone
(904) 261-5741
Fax
(904) 261-7383
NPI assigned
Aug 14, 2006
Last updated
Feb 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Dr. John W McClane III, ODNPI 1366529075
Title
President Owner
Phone
(904) 261-5741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1488 FL Primary

Addresses

Primary practice location

6 S 14TH St
Fernandina Beach, FL 32034-3212

Mailing address

6 S 14TH St
Fernandina, FL 32034-3212
Phone (904) 261-5741

Other identifiers 2

IdentifierTypeStateIssuer
078182700MedicaidFL
078226200MedicaidFL

National Provider Directory

National Provider Directory

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": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1982617619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 S 14TH ST",
            "city": "FERNANDINA",
            "state": "FL",
            "postal_code": "320343212",
            "telephone_number": "904-261-5741",
            "fax_number": "904-261-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343212",
            "telephone_number": "904-261-5741",
            "fax_number": "904-261-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCLANE & STUBITS OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "MCCLANE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "904-261-5741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "1488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078182700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "078226200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.