Susan F Blake, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

5196 Issued in OH

Practice address

2216 Lincoln Way E
Massillon, OH 44646-7062

Phone

(330) 832-9966

Fax

(330) 832-6007

NPI assigned

Feb 28, 2006

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 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Downtown Vision Center

  • Optometrist
  • Canton, OH
  • NPI 1841478989
  NPD (past)
• Fisher Foods Marketing Inc

  • Eyewear Supplier
  • Massillon, OH
  • NPI 1750441135
  NPD (past)
• Fort Mill Optical Inc

  • Optometrist
  • Fort Mill, SC
  • NPI 1548201908
  NPD (past)

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1811963705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 LINWOOD AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447085624",
            "telephone_number": "330-455-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 LINCOLN WAY E",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446467062",
            "telephone_number": "330-832-9966",
            "fax_number": "330-832-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "SUSAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "51108",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2601081",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "311529091",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NVA",
            "identifier": "22683",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "27426",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "OH5196",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VSP",
            "identifier": "202699359",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "202699359",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PCM",
            "identifier": "311529091",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VBA",
            "identifier": "OH00213",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Ohio, Inc.
• Bobbi Jane Birchler
• Bambi L. Biscan
• Kallie Renee Bishop, RN
• Dayzha Blaine
• Glenn D Blankenhorn III, DO
• Amanda N Bleigh, COTA/L
• Blossom Hearing Health, LLC
• Christine Marie Blubaugh, COTA
• Kelli M Blue, LPC

• Optometrist in Massillon, OH
• Providers in Massillon, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.