Robert M Blum, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1072 Issued in GA

Practice address

1757 E West Connector Ste 400
Austell, GA 30106-1248

Phone

(770) 941-4445

NPI assigned

Jan 16, 2007

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 GA

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

Pennsylvania College of Optometry, 1985

Medicare assignment

May accept Medicare assignment

Group practices

Family First Vision Care GeorgiaGroup PAC ID 3173934981, 8 clinicians

Austell Vision Center, Inc.Group PAC ID 4789732868, 2 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 and National Provider Directory roles.

• Austell Vision Center, Inc.

  • Optometrist
  • Austell, GA
  • NPI 1912145301
  Medicare reassignment Care Compare group NPD Authorized official
• Family First Vision Care Georgia

  • Optometrist
  • Roswell, GA
  • NPI 1649881236
  Medicare reassignment Care Compare group NPD
• Hiram Vision Center, Inc.

  • Optometrist
  • Hiram, GA
  • NPI 1144468281
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1316099088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "484 LANCASHIRE DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684275",
            "telephone_number": "678-457-0843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 E WEST CONNECTOR STE 400",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061248",
            "telephone_number": "770-941-4445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Johnson Ferry Rd",
            "address_2": "suite 148B",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300626495",
            "country_code": "US",
            "telephone_number": "678-457-0843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUM",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "1072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shanekkia Black, MD
• Elizabeth P Blackwood, NP
• Amanda Puckett Blake, CNM
• Jacob Nathan Blatt, M.D.
• Sophia Antonia Blue, LPTA
• Jennifer Boatwright, MD
• Bodyset Inc
• Richard Allen Boe Jr., MD
• Martin Boeckh
• Susan Boland, CNP

• Optometrist in Austell, GA
• Providers in Austell, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; 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.