Taylor Wade Blanco, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

9822611-9934 Issued in UT

Practice address

7555 S Center View CT Ste 101
West Jordan, UT 84084-1970

Phone

(801) 566-5683

NPI assigned

Jun 4, 2016

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

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Optometry

Education

Pacific University - College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Health Center IncGroup PAC ID 5294800611, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• UT PPO D-SNP
• UT PPO

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

• Vision Health Center, Inc.

  • Optometrist
  • West Jordan, UT
  • NPI 1558487975
  Medicare reassignment Care Compare group
• Vision Health Center, Inc.

  • Optometrist
  • Murray, UT
  • NPI 1891301966
  NPD (past)
• Vision Health Center, Inc.

  • Optometrist
  • Park City, UT
  • NPI 1952840829
  NPD (past)

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

{
    "created_epoch": "1464998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546560000000",
    "number": "1114376746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7555 S CENTER VIEW CT STE 101",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841970",
            "telephone_number": "801-566-5683",
            "fax_number": "801-255-8371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7555 S CENTER VIEW CT STE 101",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841970",
            "telephone_number": "801-566-5683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6584 Creekside Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Park City",
            "state": "UT",
            "postal_code": "840985896",
            "country_code": "US",
            "telephone_number": "435-649-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANCO",
        "first_name": "TAYLOR",
        "middle_name": "WADE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-04",
        "last_updated": "2019-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "9822611-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amie Miquelle Black
• Jessica Black
• Blackbird Care
• Boyd Kent Bladen, DDS
• Carli Joye Blake
• Malaya Bland
• Camille Blank
• Connor Bliss
• Megan Bliss
• Trista Lee Blue

• Optometrist in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.