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COASTAL VISION CENTER
NPI 1538655014
Ophthalmology in Fernandina, FL

Active since July 08, 2018CLIA 10D2303531 · Waiver
6 S 14TH ST, FERNANDINA, FL 32034(904) 261-5741(904) 261-7383 Get Directions Write a Review

NPPES record last updated: December 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 13, 2022, Sep 29, 2021, Jul 8, 2018 (3 updates tracked since 2018).

About Coastal Vision Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COASTAL VISION CENTER (NPI 1538655014) is a healthcare organization registered as an ophthalmology in Fernandina, Florida and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through April 25, 2028 and lists Nichole Rene Barnett, Practice Administrator, as its authorized official.

NPPES Registry Identity

NPI1538655014
Entity TypeOrganization
Primary Taxonomy207W00000X
Legal Business NameRUSSELL STACKHOUSE MD PA
Location Address6 S 14TH STFernandina, FL 32034-3212
Mailing Address6 S 14th StFernandina, FL 32034-3212 · (904) 261-5741 · Fax (904) 261-7383
Phone(904) 261-5741
Fax(904) 261-7383
Organization SubpartNo
Authorized OfficialNichole Rene BarnettPractice Administrator · (904) 261-5741
Enumeration DateJuly 8, 2018
Last NPPES UpdateDecember 13, 20223 updates tracked since enumeration
NPPES CertifiedDecember 13, 2022
✔ NPI 1538655014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in FL · ME117902
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOrthopaedic Surgery · Foot and Ankle SurgeryTaxonomy 207XX0004X
6 S 14TH ST, Fernandina, FL 32034
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Other Names 1

Doing Business AsCoastal Vision Center

Other Identifiers 1

Other070583Date Of Birth

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2303531

Coastal Vision Center · Fernandina Beach, FL
Active · expires Apr 25, 2028
CLIA Number10D2303531
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2026
Certificate Expiration DateApril 25, 2028
Laboratory DirectorRussell Stackhouse
Laboratory Phone(904) 261-5741
Laboratory LocationCoastal Vision Center2416 Lynndale Rd Suite 201, Fernandina Beach, FL 32034
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEAH LENTZ HERRON O.D.
Optometrist
6 S 14TH ST
FERNANDINA, FL 32034
Nassau County (904) 261-5741
DR. KATELYN MARIE MARKS OD
Optometrist
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741
TYLER ANDREW WILLS OD
Optometrist
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741
JAMES RUSSELL KELLER STACKHOUSE MD
Ophthalmology
6 S 14TH ST
FERNANDINA, FL 32034
Nassau County (904) 261-5741
ANSLEY MIDDLETON SCHUEPBACH OD
Optometrist
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741
COLIN MILO
Optometrist
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741
DR. CAPRITTA ROBERTS D.O.
Ophthalmology
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741
MCCLANE & STUBITS OD PA
Optometrist
6 S 14TH ST
FERNANDINA BEACH, FL 32034
Nassau County (904) 261-5741

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Stackhouse MD PA's NPI number?

The NPI number for Russell Stackhouse MD PA is 1538655014. It was assigned to this organization in the NPPES registry on July 8, 2018. The provider is doing business as Coastal Vision Center.

Where is Russell Stackhouse MD PA located?

Russell Stackhouse MD PA is located at 6 S 14th St, Fernandina, FL 32034. The listed phone number is (904) 261-5741.

What is Russell Stackhouse MD PA's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Does Russell Stackhouse MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2303531) is associated with this NPI, valid through April 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Russell Stackhouse MD PA accept?

Health plans from BlueCross BlueShield of Tennessee, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and Molina Healthcare list Russell Stackhouse MD PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Russell Stackhouse MD PA was last updated on December 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.