Individual provider Active NPI

Jazmin C. Blankman, O.D.

  • Optometrist
  • Harrison, OH
National Provider Identifier
1255375077
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2254DT Issued in KY
Practice address
10051A Simonson Rd
Suite 3
Harrison, OH 45030-2165
Phone
(513) 367-4262
NPI assigned
Jun 15, 2006
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OH5208 OH
Optometrist 152W00000X 2254DT KY Primary

Addresses

Primary practice location

10051A Simonson Rd
Suite 3
Harrison, OH 45030-2165

Mailing address

10051A Simonson Rd
Suite 3
Harrison, OH 45030-2165
Phone (513) 367-4262

Other practice location 1

1401 Madison Ave
Covington, KY 41011-3313
Phone (859) 655-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20051213000101 OH Practitioner - Optometry 4385665884 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OH5208OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Ronald Cooke & George Landon Optometrists LLC Optometrist CurrentSince Sep 7, 2016 Accepting new patients
Opticare Vision Centers, LLC Optometrist Past Accepting new patients

Locations

10051A Simonson Rd
Ste 3
Harrison, OH 45030
Phone (513) 367-4262

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1255375077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10051A SIMONSON RD",
            "address_2": "SUITE 3",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302165",
            "telephone_number": "513-367-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10051A SIMONSON RD",
            "address_2": "SUITE 3",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302165",
            "telephone_number": "513-367-4262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "KY",
            "postal_code": "410113313",
            "country_code": "US",
            "telephone_number": "859-655-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLANKMAN",
        "first_name": "JAZMIN",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "OH5208",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "2254DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, OH

Sources for this page

Verify at the official NPI Registry.