Individual Healthcare Provider
Edward Mitchell, LDO
Provider's NPPES record last updated: October 15, 2019
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1811139462
- Primary Specialty
- Eyewear Supplier
- Practice Location
- Crestview, Florida
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 12:57 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Eyewear Supplier
Suppliers
An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
Taxonomy code 332H00000X Technician/Technologist
Contact Lens Fitter
Eye and Vision Services Providers
An optician or other ancillary support staff person who, where authorized by state law and trained or certified to do so, may fit or dispense contact lenses to a patient based on the prescription of an optometrist or medical physician.
Taxonomy code 156FC0801XTechnician/Technologist
Optician
Eye and Vision Services Providers
Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.
Taxonomy code 156FX1800X
Provider-Reported License Information
- Eyewear Supplier (Florida)
- DO5539
- Technician/Technologist (Florida)
- DO 5539
- Technician/Technologist (Florida)
- DO 5539
- Technician/Technologist (Florida)
- 5539
Practice Locations
Practice Location
4100 S Ferdon Blvd Ste B5
Crestview, Florida 32536-5287
Phone: (850) 758-0474
Additional Practice Location
4724 Whitewater Ln
Crestview, Florida 32539-5725
Phone: (850) 826-0698
Fax: (850) 423-0142
Record Information
- Enumeration Date
- March 28, 2009
- Provider's NPPES Record Last Updated
- October 15, 2019
- NPISignal NPPES Dataset
- August 2026
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