Individual provider Active NPI

Mary Lynne Blevins, O.D.

  • Optometrist
  • Louisville, OH
National Provider Identifier
1275612525
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3739 Issued in OH
Practice address
503 E Main St
Louisville, OH 44641-1421
Phone
(330) 875-2300
Fax
(330) 875-4110
NPI assigned
Nov 6, 2006
Last updated
Oct 27, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3739 OH Primary

Addresses

Primary practice location

503 E Main St
Louisville, OH 44641-1421

Mailing address

503 E Main St
Louisville, OH 44641-1421
Phone (330) 875-2300

Other identifiers 2

IdentifierTypeStateIssuer
0561315MedicaidOH
410046640OtherOHRAILROAD MEDICARE

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
I20120402000465 OH Practitioner - Optometry 7012177884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blevins and Blevins, Inc.Group PAC ID 3678692985, 4 clinicians

Practice addresses (Care Compare)

503 E Main St
Louisville, OH 44641-1421
Phone (330) 875-2300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3739OHMDPsychologist

Organizations & group practices 1

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225065600000",
    "number": "1275612525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 E MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411421",
            "telephone_number": "330-875-2300",
            "fax_number": "330-875-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 E MAIN ST",
            "city": "LOUISVILLE",
            "state": "OH",
            "postal_code": "446411421",
            "telephone_number": "330-875-2300",
            "fax_number": "330-875-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "MARY",
        "middle_name": "LYNNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2008-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0561315",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410046640",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, OH

Sources for this page

Verify at the official NPI Registry.