Donald W Blocker, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OD0454 Issued in TN

Practice address

605 S Broadway
Portland, TN 37148-1619

Phone

(615) 325-2020

Fax

(615) 325-5862

NPI assigned

May 17, 2006

Last updated

Feb 19, 2008By the provider in NPPES

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

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Donald W Blocker DO

  dba Portland Vision Clinic

  • Eyewear Supplier
  • Portland, TN
  • NPI 1609078229
  Authorized official Same address or phone

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1396798013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S BROADWAY",
            "address_2": "P O BOX 470",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371481619",
            "telephone_number": "615-325-2020",
            "fax_number": "615-325-5862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S BROADWAY",
            "city": "PORTLAND",
            "state": "TN",
            "postal_code": "371481619",
            "telephone_number": "615-325-2020",
            "fax_number": "615-325-5862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "DONALD",
        "middle_name": "W",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "OD0454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3595433",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chrystall Faye Beitel, CPM-TN
• Stephanie Bentley, PHARMD
• Latoya Blake
• Joshua Bland, MD
• Lester Steve Blevins
• Trevor Benjamin Brandt, DPT
• Sancia Renee Brooks
• Natalie Elizabeth Brown, RN
• Jason A Bruns, BSPT
• Felicia Butler, MSN, APRN, FNP-BC

• Optometrist in Portland, TN
• Providers in Portland, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.