Jerry R Blair, M.D., PH.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

108058 Issued in MO

Practice address

3600 Amron CT
Columbia, MO 65202-1918

Phone

(573) 874-1616

Fax

(573) 875-0300

NPI assigned

Dec 2, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

98.72 of 100Reported as group

Quality

97.43

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Retina Associates of Missouri, P.C.

  • Retina Specialist (Ophthalmology) Physician
  • Columbia, MO
  • NPI 1144204553
  Medicare reassignment NPD Authorized official
• Retina Associates of Mid Missouri, LLC

  • Retina Specialist (Ophthalmology) Physician
  • Columbia, MO
  • NPI 1235729377
  NPD Authorized official

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1790769701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 AMRON CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021918",
            "telephone_number": "573-874-1616",
            "fax_number": "573-875-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 AMRON CT",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652021918",
            "telephone_number": "573-874-1616",
            "fax_number": "573-875-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "JERRY",
        "middle_name": "R",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207WX0107X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Retina Specialist",
            "state": "MO",
            "license": "108058",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "108058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207965708",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5388",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joel M Blackburn, D.O.
• Jameson Tanner Blackford, PHARMD
• Heidi Annette Blackstun, MSW, LCSW, MBA
• Deborah Ann Blain, CHIROPRACTOR
• Brian Wesley Blair
• Mallory E Blair, PMHNP-BC
• Megan Renee Blakemore, PA-C
• Brandyn P Blank, PA-C
• Brian Blankenship, MD
• McKenna S Blankenship, MSW, LCSW

• Ophthalmology Physician in Columbia, MO
• Providers in Columbia, MO by specialty
• Ophthalmology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.