Mindy M Blackford, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2006018231 Issued in MO

Practice address

404 S Elson St
Kirksville, MO 63501-3449

Phone

(660) 665-3564

Fax

(660) 665-2202

NPI assigned

Jul 27, 2006

Last updated

Apr 28, 2021By the provider in NPPES

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

Electronic endpoints 1

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sloan Eyecare Center L.L.CGroup PAC ID 6103891825, shared by 5 NPIs, 8 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@premiereyecareassociateschillicothemo.compulinkdirect.com

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.

• Sloan Eyecare Center L.L.C

  dba Premier Eyecare Associates

  • Optometrist
  • Brookfield, MO
  • NPI 1013051390
  Medicare reassignment NPD
• Sloan Eyecare Center LLC

  dba Premier EyeCare Associates

  • Optometrist
  • Chillicothe, MO
  • NPI 1568519643
  Medicare reassignment NPD
• Sloan Eyecare Center L.L.C

  dba Premier Eyecare Associates

  • Optometrist
  • Trenton, MO
  • NPI 1457495731
  NPD
• Sloan Eyecare Center L.L.C

  dba Premier Eyecare Associates

  • Optometrist
  • Kirksville, MO
  • NPI 1740757186
  NPD
• Timothy D McGarity MD PC

  • Ophthalmology Physician
  • Columbia, MO
  • NPI 1912299884
  NPD (past)

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619568000000",
    "number": "1861406092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S ELSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013449",
            "telephone_number": "660-665-3564",
            "fax_number": "660-665-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 S ELSON ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635013449",
            "telephone_number": "660-665-3564",
            "fax_number": "660-665-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKFORD",
        "first_name": "MINDY",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2006018231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317585305",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@PremierEyeCareAssociatesChillicotheMO.CompulinkDirect.com",
            "affiliation": "N",
            "address_1": "404 S Elson St",
            "city": "Kirksville",
            "state": "MO",
            "country_code": "US",
            "postal_code": "635013449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacie Bevill, PNP
• Ann Marie Bibbs, MSN, RN, NP-C
• Jordan Billington
• Heather Rachelle Bird, DO
• Samantha Jane Bishop, M.A., CCC-SLP
• Jennifer Lynn Blacksmith, PH.D
• Jennifer L Blanke, DPT
• Kent James Blanke, DO
• Leah Blaskowski
• Madison Blauer

• Optometrist in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2021; 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.