Kenny Ray Blackston, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S950-TA-529 Issued in AL

Practice address

102 W Covington Ave
Opp, AL 36467-2033

Phone

(334) 774-9396

Fax

(334) 774-1459

NPI assigned

Jun 28, 2005

Last updated

Jan 17, 2008By the provider in NPPES

Sex

Male

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 AL

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

Specialty

Optometry

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.34 of 100Reported as individual

Quality

56.69

Improvement activities

40

Procedures performed for Medicare patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kenny R Blackston OD PC

  • Optometrist
  • Andalusia, AL
  • NPI 1710028618
  Medicare reassignment NPD
• D & J Optical Inc

  dba Denney Vision

  • Optometrist
  • Opp, AL
  • NPI 1447257910
  NPD (past)
• D & J Optical Inc

  dba Crosby Vision

  • Optometrist
  • Ozark, AL
  • NPI 1669478236
  NPD (past)
• Eye Surgical Associates P C

  • Ophthalmology Physician
  • Dothan, AL
  • NPI 1669648879
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1740286301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W COVINGTON AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364672033",
            "telephone_number": "334-774-9396",
            "fax_number": "334-774-1459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W COVINGTON AVE",
            "city": "OPP",
            "state": "AL",
            "postal_code": "364672033",
            "telephone_number": "334-774-9396",
            "fax_number": "334-774-1459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTON",
        "first_name": "KENNY",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-28",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S950-TA-529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE PROV #",
            "identifier": "22-10508",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Devane Anderson, RRT
• George Lawrence Arnett, BA, BC-HIS
• Bhagwan D Bang, M.D.
• Nicholas Bass, AGPCNP-BC
• Ashley Jean Basso
• Blissful Healthcare LLC
• Selena Bluck
• Katie Spurlin Bowers, CRNP
• Juliana Shea Broder
• Charles M Burgess Jr., DMD

• Optometrist in Opp, AL
• Providers in Opp, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.