Jacob Carl Yates

Optometrist · Palm Coast, FL

Individual Active NPI

NPI number 1780412957

Practice location

15 Cypress Branch Way Ste 205
Palm Coast, FL 32164-8414
Phone
(386) 445-1880

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NPI record

NPI
1780412957
Entity type
Individual (Type 1)
Enumeration date
July 22, 2024
Last updated
December 19, 2024
Certified
December 19, 2024
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Optometrist Primary 152W00000X OPC6592 FL
Optometrist 152W00000X 2416DT KY

Mailing address

8614 Westwood Center Dr Fl 9
Vienna, VA 22182-2442
Phone
(703) 847-8899

About Jacob Yates

Jacob Carl Yates is a healthcare provider registered in the NPI registry with the primary taxonomy Optometrist (code 152W00000X). The practice location is 15 Cypress Branch Way Ste 205, Palm Coast, FL 32164-8414. The NPI number 1780412957 was assigned on July 22, 2024 and the record was last updated on December 19, 2024.

Jacob Yates lists 2 licenses in the registry: #OPC6592 (FL) for Optometrist; #2416DT (KY) for Optometrist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jacob Carl Yates?

The NPI number is 1780412957.

What is the phone number of Jacob Yates?

The phone number listed for the practice location is (386) 445-1880.

Where is Jacob Yates located?

15 Cypress Branch Way Ste 205, Palm Coast, FL 32164-8414.

What is the taxonomy code for Jacob Yates?

The primary taxonomy code is 152W00000X – Optometrist; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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