Individual provider Active NPI

Gilbert C Blanks, O.D.

  • Optometrist
  • Jackson, MI
National Provider Identifier
1114917317
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901003044 Issued in MI
Practice address
1015 Laurence Ave
Jackson, MI 49202-2964
Phone
(517) 787-0364
Fax
(517) 787-2272
NPI assigned
Oct 27, 2005
Last updated
Dec 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901003044 MI Primary

Addresses

Primary practice location

1015 Laurence Ave
Jackson, MI 49202-2964

Mailing address

1015 Laurence Ave
Jackson, MI 49202-2964
Phone (517) 787-0364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20061027000471 MI Practitioner - Optometry 7315970761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Center for Sight PCGroup PAC ID 6507899952, 5 clinicians

Practice addresses (Care Compare)

1015 Laurence Ave
Jackson, MI 49202-2964
Phone (517) 787-0364

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901003044MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Sight P.C. Optometrist CurrentSince May 1, 2010 Accepting new patients
The Center for Sight, P.C. Optometrist CurrentSince Jun 1, 2000 Accepting new patients

Locations

1015 Laurence Ave
Jackson, MI 49202
Phone (517) 787-0364

Interoperability endpoints

  • Direct secure messaging: gblanks725738@direct.hfhs.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1114917317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022964",
            "telephone_number": "517-787-0364",
            "fax_number": "517-787-2272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 LAURENCE AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022964",
            "telephone_number": "517-787-0364",
            "fax_number": "517-787-2272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANKS",
        "first_name": "GILBERT",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-27",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901003044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.