Dr Gary L Blackman Optometrist, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DR GARY L BLACKMAN OPTOMETRIST, LLC

Practice address

16 Madera CT
Taylorville, IL 62568-8927

Phone

(217) 553-7709

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gary L Blackman, OD

Title

Owner

Phone

(217) 553-7709

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349481600000",
    "number": "1588933501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MADERA CT",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625688927",
            "telephone_number": "217-553-7709",
            "fax_number": "217-303-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MADERA CT",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625688927",
            "telephone_number": "217-553-7709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GARY L BLACKMAN OPTOMETRIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2012-10-06",
        "status": "A",
        "authorized_official_last_name": "BLACKMAN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-553-7709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Taylorville, IL
• Providers in Taylorville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2012; 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.