Samantha Ann Blanke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ATI4665 Issued in OR

Practice address

2174 Dixie Hwy
Ft Mitchell, KY 41017-2972

Phone

(859) 341-2566

NPI assigned

May 5, 2023

Last updated

Jul 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Southern College of Optometry, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Shewmaker and Associates Optometrists IncGroup PAC ID 7719874049, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Shewmaker & Associates Optometrists Inc

  dba Vision One

  • Optometrist
  • Ft Mitchell, KY
  • NPI 1871641332
  Medicare reassignment Care Compare group NPD
• Dr Shewmaker & Associates Optometrists Inc

  dba Vision One

  • Optometrist
  • Dry Ridge, KY
  • NPI 1801949227
  NPD

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1245929140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3405 WOODLAND DR",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542209664",
            "telephone_number": "920-905-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2174 DIXIE HWY",
            "city": "FT MITCHELL",
            "state": "KY",
            "postal_code": "410172972",
            "telephone_number": "859-341-2566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15259 SE 82nd Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Clackamas",
            "state": "OR",
            "postal_code": "970156609",
            "country_code": "US",
            "telephone_number": "920-905-2836",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1114 Fashion Ridge Rd # Vision1",
            "address_purpose": "LOCATION",
            "city": "Dry Ridge",
            "state": "KY",
            "postal_code": "410359609",
            "country_code": "US",
            "telephone_number": "859-824-4415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKE",
        "first_name": "SAMANTHA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-05",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "ATI4665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Ft Mitchell, KY
• Providers in Ft Mitchell, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; 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.