CONGLETON EYE CARE, LLC (NPI# 1750761375) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750761375 |
| Entity Type | Organization |
| Organization Name | CONGLETON EYE CARE, LLC |
| Practice Address |
4600 Mobile Hwy Suite 122 Pensacola FL 32506 |
| Mailing Address |
4600 Mobile Hwy #9 Pmb 139 Pensacola FL 32506 |
| Practice Telephone | 8504550722 |
| Practice Fax Number | 8504550723 |
| Mailing Telephone | 8504550722 |
| Mailing Fax Number | 8504550723 |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | JAMIE CONGLETON (PRESIDENT) |
| Authorized Official Telephone | 8504550722 |
| Authorized Official Credential | O.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FLORIDA MEDICARE - INDIVIDUAL PTAN | IG570Z | 01 | |
| FL | MEDICARE GROUP PTAN | IG569A | 01 |
| Street Address |
4600 MOBILE HWY SUITE 122 |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184225146 | Kelli P Wright | Pharmacist | 4600 Mobile Hwy, Pensacola, FL 32506-3508 | 2020-11-05 |
| 1154932911 | Tristan Cox | Pharmacist | 4600 Mobile Hwy, Pensacola, FL 32506-3508 | 2020-08-13 |
| 1578945705 | Jamie Congleton | Optometrist | 4600 Mobile Hwy, Suite 122, Pensacola, FL 32506-3508 | 2015-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093332942 | Abigail Irene Dudek | Behavior Technician | 6800 West Us-98, Pensacola, FL 32506 | 2020-06-26 |
| 1053957274 | Melissa Marie Swango | Technician | 3 Usher Cir, Pensacola, FL 32506 | 2019-11-22 |
| 1215479506 | Kerry Jo Pham | Advanced Practice Midwife | 225 N New Warrington Rd, Pensacola, FL 32506 | 2016-11-17 |
| 1033312293 | Rogelio Tridanio Martinez Sr. | Pain Medicine | 4806 Mobile Highway, Suite D, Pensacola, FL 32506 | 2007-06-06 |
| 1215023726 | Martha Goff | Pharmacist | 50 S. Blue Angel Parkway, Pensacola, FL 32506 | 2006-10-04 |
| 1881703635 | John Daniel Hodge | Dentist | 4800 W Fairfield Dr, Pensacola, FL 32506 | 2006-08-29 |
| 1417066275 | Fairfield Dental Center | Dentist | 4800 W. Fairfield Drive, Pensacola, FL 32506 | 2006-08-29 |
| 1942277793 | Phillip Martine Drlicka | Dentist | 901 N Warrington Rd, Pensocola, FL 32506 | 2006-03-01 |
| 1083694186 | Lester Shawn Bowling | Internal Medicine | 321 South Fairfield Dr, Pensacola, FL 32506 | 2006-01-17 |
| 1114433166 | Stephanie E Hattaway | Nurse Practitioner | 4929 Mobile Hwy, Pensacola, FL 32506 | 2017-12-28 |
| Find all providers in zip 32506 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104470350 | Abby Luray Nice | Optometrist | 1630 Airport Blvd Ste 230, Pensacola, FL 32504-8637 | 2019-07-26 |
| 1013431600 | Megan Wohlers | Optometrist | 12591 Sorrento Rd Ste B, Pensacola, FL 32507 | 2017-07-26 |
| 1124481676 | Star Rostankovski | Optometrist | 6700 N Davis Hwy, Pensacola, FL 32504-6304 | 2016-04-01 |
| 1164789806 | Daniel & Max | Optometrist | 7000 N Davis Hwy # A, Pensacola, FL 32504-6309 | 2012-04-19 |
| 1902128960 | Owens & Reynolds Inc | Optometrist | 800 N 12th Ave, Pensacola, FL 32501-3303 | 2010-02-18 |
| 1447491238 | Barry J Stein Od Pa | Optometrist | 6601 N Davis Hwy Ste 1b, Pensacola, FL 32504-6210 | 2009-03-09 |
| 1063665693 | Rodney Taylor | Optometrist | 46 Faison St, Pensacola, FL 32505-1885 | 2008-10-28 |
| 1831345503 | Paul Raymond Mayo II | Optometrist | 450 Turner St Bldg 3600, Pensacola, FL 32508-5211 | 2008-08-13 |
| 1457416562 | Coastal Family Eyecare Inc | Optometrist | 3960 W Navy Blvd, Suite 1, Pensacola, FL 32507-1265 | 2006-12-27 |
| 1316000524 | Joseph Scott Schlesinger | Optometrist | 5145 Leesway Cir, Pensacola, FL 32504-4310 | 2006-12-18 |
| Find all providers in PENSACOLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.