Larry E Blackmon, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

693-077T Issued in LA

Practice address

303 McMillan Rd
West Monroe, LA 71291-8316

Phone

(318) 387-7257

Fax

(318) 325-7034

NPI assigned

Feb 1, 2007

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

Other identifiers 5

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

• Blackmon & Blackmon Inc

  • Optometrist
  • West Monroe, LA
  • NPI 1992983340
  NPD (past) Authorized official

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1902944341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 MCMILLAN RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918316",
            "telephone_number": "318-387-7257",
            "fax_number": "318-325-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 MCMILLAN RD",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712918316",
            "telephone_number": "318-387-7257",
            "fax_number": "318-325-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "LARRY",
        "middle_name": "E",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "693-077T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "LA0693",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "0617300002",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1097721",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF LA",
            "identifier": "2353B",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "2864",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Bingham, SLP
• Bio-Medical Applications of Louisiana, LLC (Bma Ouachita Dialysis)
• Bionet Medical LLC
• Marilyn Grisham Bivens, M.D.
• Blackmon & Blackmon Inc
• Lauren Sledge Blackmon, SLP
• Megan Blackwell
• Nancy Blanchard, EDS, NCC, LPC
• Laura Blaylock, PHYSICAL THERAPIST
• Thomas G. Block III, DO

• Optometrist in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2008; 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.