William Thomas Black, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ID0857 Issued in ID

Practice address

420 E Elm St
Caldwell, ID 83605-4846

Phone

(208) 459-2020

Fax

(208) 459-2034

NPI assigned

Nov 2, 2006

Last updated

Aug 30, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rexford Capital Partners, Inc

  dba Armstrong-Root Opticians

  • Optometrist
  • Ketchum, ID
  • NPI 1629368725
  Medicare reassignment NPD
• Family Eyecare Specialists PLLC

  dba William T Black

  • Optometrist
  • Caldwell, ID
  • NPI 1588840557
  Medicare reassignment
• Insight Optical

  • Optometrist
  • Caldwell, ID
  • NPI 1588830665
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1063591162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-2020",
            "fax_number": "208-459-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E ELM ST",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054846",
            "telephone_number": "208-459-2020",
            "fax_number": "208-459-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "WILLIAM",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ID0857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002752500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John K Bishop, LPC LICENSED PROFESS
• Bora Bisimwa
• Georgette Bisoka
• J'Cinda J'Nae Bitters, MD
• Amy Jo Bizik, PMHNP
• Blaisdell Dental Center, PA
• John David Blaisdell, D.D.S.
• Thomas Lagrand Blaisdell, D.D.S.
• Jessica D Blancett, DO
• Sierra Faith Blanke

• Optometrist in Caldwell, ID
• Providers in Caldwell, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.