Jennifer Blakemore, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901005135 Issued in MI

Practice address

10791 Belleville Rd
Van Buren TWP, MI 48111

Phone

(734) 391-3080

Fax

(734) 345-5901

NPI assigned

May 31, 2018

Sex

Female

Sole proprietor

No

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 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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• SVS Vision Inc

  • Optometrist
  • Mount Clemens, MI
  • NPI 1194879023
  Medicare reassignment NPD
• SVS Vision Inc

  dba SVS Vision 94

  • Optometrist
  • Mt Pleasant, MI
  • NPI 1558246942
  NPD

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1699267278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 CASS AVE",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480432204",
            "telephone_number": "586-468-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10791 BELLEVILLE RD",
            "city": "VAN BUREN TWP",
            "state": "MI",
            "postal_code": "48111",
            "telephone_number": "734-391-3080",
            "fax_number": "734-345-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMORE",
        "first_name": "JENNIFER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699267278",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamye Renee Banks, PHD
• Kenyatta Barbee
• Beatrix LLC
• Ali M Berry, PHARMD
• Betterlife Caring Hands LLC
• Brittany Denis PLLC
• Brittany Sanders LMSW PLLC
• Roderick Stephen Burbank I
• Gabrielle Burgess-Smith
• Courtney Caudill-Singleton, MS

• Optometrist in Van Buren TWP, MI
• Providers in Van Buren TWP, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.