Darren Robert Blom, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC2976 Issued in FL

Practice address

7205 Bonneval Rd
Jacksonville, FL 32256-7565

Phone

(904) 696-9486

Fax

(904) 696-3422

NPI assigned

Mar 15, 2007

Last updated

Feb 22, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare assignment

May accept Medicare assignment

Group practices

Dr. Ted Brink and Associates PAGroup PAC ID 6800936360, 12 clinicians

Practice addresses (Care Compare)

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.

• Dr. Ted Brink and Associates PA

  • Optometrist
  • Jacksonville, FL
  • NPI 1427138650
  Medicare reassignment Care Compare group NPD
• Family First Vision Care, PLLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1104341882
  Medicare reassignment NPD
• Dr.Ted Brink & Associates

  • Optometrist
  • Jacksonville, FL
  • NPI 1730402686
  NPD
• Regency Eye Care LLC

  • Optometrist
  • Jacksonville, FL
  • NPI 1912151606
  NPD (past)

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266796800000",
    "number": "1902930605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 W GLENDALE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322594527",
            "telephone_number": "904-287-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7205 BONNEVAL RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567565",
            "telephone_number": "904-696-9486",
            "fax_number": "904-696-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOM",
        "first_name": "DARREN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC2976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Block, OTR/L, MSOT
• Cole Matthew Blodgett, DDS
• Megan M Bloemker
• Blog Planet LLC (Zion Health Center)
• Martina Blokker
• Billy Eugene Blomberg, BCPC
• Alicia Karol Blong, RD
• Katira Maelena Bloodsaw
• Kathaleen C Bloom, CNM
• Richard R Bloom, DC

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2010; 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.