Individual provider Active NPI

Jacquelyn Williams-Blakey, O.D.

  • Optometrist
  • Detroit, MI
National Provider Identifier
1639217722
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
JW003785 Issued in MI
Practice address
71 Garfield St.
Ste. 180
Detroit, MI 48201-1911
Phone
(313) 974-7299
Fax
(313) 974-7525
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X JW003785 MI Primary

Addresses

Primary practice location

71 Garfield St.
Ste. 180
Detroit, MI 48201-1911

Mailing address

18331 Fairfield St
Detroit, MI 48221
Phone (313) 574-0131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20120702000179 MI Practitioner - Optometry 7113182874 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
JW003785MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sharper Vision PC CurrentSince May 30, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1639217722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18331 FAIRFIELD ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48221",
            "telephone_number": "313-574-0131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 GARFIELD ST.",
            "address_2": "STE. 180",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482011911",
            "telephone_number": "313-974-7299",
            "fax_number": "313-974-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS-BLAKEY",
        "first_name": "JACQUELYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "JW003785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.