Delaware Vision Academy LLC

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

I3-0001218 Issued in DE

Legal business name

DELAWARE VISION ACADEMY LLC

Practice address

3105 Limestone Rd
Suite 102
Wilmington, DE 19808-2147

Phone

(302) 998-1395

Fax

(302) 998-6784

NPI assigned

Feb 22, 2007

Last updated

Feb 27, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Don David Blackburn, O.D.NPI 1639271216

Title

President

Phone

(302) 998-1395

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Don D Blackburn, OD

  • Vision Therapy Optometrist
  • Wilmington, DE
  • NPI 1639271216
  Medicare reassignment Care Compare group Authorized official
• Linen J Pok, OD

  • Optometrist
  • Newark, DE
  • NPI 1710906730
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235692800000",
    "number": "1518092659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 CUNANE CIR",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197022074",
            "telephone_number": "302-998-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 LIMESTONE RD",
            "address_2": "SUITE 102",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198082147",
            "telephone_number": "302-998-1395",
            "fax_number": "302-998-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELAWARE VISION ACADEMY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2009-02-27",
        "status": "A",
        "authorized_official_last_name": "BLACKBURN",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-998-1395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "DE",
            "license": "I3-0001218",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Pediatrics",
            "state": "DE",
            "license": "I3-0001218",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Sports Vision",
            "state": "DE",
            "license": "I3-0001218",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "DE",
            "license": "I3-0001218",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "DE",
            "license": "I3-0001218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "258125",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vision Therapy Optometrist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Vision Therapy Optometrist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.