Douglas K Blackman, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

9801 Issued in KS

Practice address

1851 N Webb Rd
Wichita, KS 67206

Phone

(316) 636-2010

Fax

(316) 858-3830

NPI assigned

Mar 1, 2006

Last updated

Apr 3, 2008By the provider in NPPES

Sex

Male

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1982671806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "address_2": "ATTN FLR2",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063413",
            "telephone_number": "316-636-2010",
            "fax_number": "316-858-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67206",
            "telephone_number": "316-636-2010",
            "fax_number": "316-858-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "DOUGLAS",
        "middle_name": "K",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "9801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CD2825",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura M Black, PA-C
• Mariah Black, PHARMD
• Katie Blackbourn
• Karen N Blackburn, PA-C
• Zachary Blackhurst, PHD
• Jacques D Blackman, MD
• Sheila Blackmon, RN
• Amanda J Blackmore, PA-C
• Jonathan D Blackwell, T-LPC
• Meryiah Blaine, LMLP-T

• Optometrist in Wichita, KS
• Providers in Wichita, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.