Blackstone Valley Optometry PC
Organization Active NPI Optometrist · Woonsocket, RI
NPI 1669976858 · NPPES record last updated Mar 21, 2018
Key facts
- NPI
- 1669976858
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- Legal business name
- BLACKSTONE VALLEY OPTOMETRY PC
- Practice address
- 385 Mendon Rd Ste 2
Woonsocket, RI 02895-2430 - Phone
- (401) 762-2011
- NPI assigned
- Mar 21, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey Steven Kenyon
- Title
- President
- Phone
- (401) 762-2011
Practitioners 1
-
Jeffrey Steven Kenyon, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190729001916 | RI | Part B Supplier - Clinic/Group Practice | 3779819727 |
Receives reassigned benefits from 1 practitioner Practice locations: Woonsocket, RI |
National Provider Directory
Locations
385 Mendon Rd
Ste 2
Woonsocket, RI 02895
Phone (401) 762-2011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | Yes |
Addresses
Primary practice location
385 Mendon Rd Ste 2
Woonsocket, RI 02895-2430
Mailing address
385 Mendon Rd Ste 2
Woonsocket, RI 02895-2430
Phone (401) 762-2011
Other providers in Woonsocket, RI
- Blackstone Medical Center, Inc.
- Blackstone Medical Center, Inc.
- Blackstone Valley Center for Internal Medicine, Inc
- Blackstone Valley Center for Internal Medicine,Inc.
- Blackstone Valley Eye Care, P.C.
- Abigail Blais
- Andrew Cecil Blake Jr.
- Leslie Arleen Bluett
- Megan Boateng
- Linda Carole Boden
All providers in Woonsocket, RI · Optometrist in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.