Blaine F. Bird, O.D., P.C.

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

1145549934 Issued in UT

Legal business name

BLAINE F. BIRD, O.D., P.C.

Practice address

2255 N University Pkwy
Suite #1
Provo, UT 84604-1588

Phone

(801) 374-2220

Fax

(801) 373-5439

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Blaine F Bird, O.D.

Title

President

Phone

(801) 374-2220

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1083817944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 N UNIVERSITY PKWY STE 1",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846047505",
            "telephone_number": "801-374-2220",
            "fax_number": "801-373-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 N UNIVERSITY PKWY",
            "address_2": "SUITE #1",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846041588",
            "telephone_number": "801-374-2220",
            "fax_number": "801-373-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE F. BIRD, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "BIRD",
        "authorized_official_first_name": "BLAINE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-374-2220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "UT",
            "license": "1145549934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1871581652",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529961264004",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darci Jean Blackett
• Andrea Blackham
• David Maurice Blackwell, PA-C
• Elizabeth K Blackwell, MD
• Kent Blad, FNP
• Chelsea Marie Borup Blair, CSW
• Tarlton J Blair, MD
• Jaren H. Blake, MD
• Harold Herbert Blakelock
• Michael Steven Blakey

• Eyewear Supplier in Provo, UT
• Providers in Provo, UT by specialty
• Eyewear Supplier in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.