Craig Blackwell, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G52516 Issued in CA

Practice address

1667 Dominican Way
Ste 130
Santa Cruz, CA 95065-1529

Phone

(831) 462-9225

Fax

(831) 462-6285

NPI assigned

May 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1326041195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1667 DOMINICAN WAY",
            "address_2": "STE 130",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651529",
            "telephone_number": "831-462-9225",
            "fax_number": "831-462-6285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1667 DOMINICAN WAY",
            "address_2": "STE 130",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651529",
            "telephone_number": "831-462-9225",
            "fax_number": "831-462-6285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "CRAIG",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G52516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G525160",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail Rene Black, MFT
• Lisa Black, PSYD
• Mary A Black, L.AC, MTCM, DIPL.O.M
• Carolyn Sue Blackman, RN, LCSW
• Sara Blackstorm Atton, DTCM
• Rachel Blackwell
• Krista Bladel
• Hailey Lila Blair
• Lorinda M Blake, RN
• Timothy Blakeslee, DPM

• Ophthalmology Physician in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.