DONALD W BLOCKER DO (NPI# 1609078229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609078229 |
| Entity Type | Organization |
| Organization Name | DONALD W BLOCKER DO |
| Other Organization Name | PORTLAND VISION CLINIC |
| Practice Address |
605 S Broadway Portland TN 37148-1619 |
| Mailing Address |
Po Box 470 Portland TN 37148-0470 |
| Practice Telephone | 6153252020 |
| Practice Fax Number | 6153255862 |
| Mailing Telephone | 6153252020 |
| Mailing Fax Number | 6153255862 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2014-10-24 |
| NPI Deactivation Date | 09/25/2007 |
| NPI Reactivation Date | 2008-03-04 |
| Authorized Official Name | DONALD W BLOCKER (OWNER OPTOMETRIST) |
| Authorized Official Telephone | 6153252020 |
| Authorized Official Credential | OD |
| Is Organization Subpart | Y |
| Parent Organization Name | DONALD W BLOCKER OD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Portland Vision Clinic | Doing Business As Name - Organization |
| Street Address |
605 S BROADWAY |
| City | PORTLAND |
| State | TN |
| Zip Code | 37148-1619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396798013 | Donald W Blocker | Optometrist | 605 S Broadway, Portland, TN 37148-1619 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427608645 | Carehere LLC | Family Medicine | Carehere Clinic- Nasg Portland, Tn, 160 Kirby Drive, Portland, TN 37148 | 2019-09-19 |
| 1710494117 | Lydia Ellen Hicks | Registered Nurse | 214 W. Longview Drive, Portland, TN 37148 | 2018-01-08 |
| 1487903696 | Jennifer Leigh Toney | Registered Nurse | 101 Maurice Ct, Portland, TN 37148 | 2012-09-04 |
| 1366712770 | Pamela Poghen | Registered Nurse | 235 Hwy 52 E, Portland, TN 37148 | 2012-01-03 |
| 1003090036 | State of Tennessee | Public Health or Welfare | 214 West Longview Drive, Portland, TN 37148 | 2007-12-27 |
| 1437256930 | Tennessee Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 304 A S Broadway Ste A, Portland, TN 37148 | 2006-09-20 |
| 1568494243 | Melissa R Cook | Nurse Practitioner | 932-b South Broadway, Portland, TN 37148 | 2006-07-06 |
| 1225200306 | Lisa Nazarenus | Nurse Practitioner | 307 S Broadway, Portland, TN 37148 | 2008-03-28 |
| 1770523748 | Jason A Bruns | Physical Therapist | 121 Village Dr, 103, Portland, TN 37148 | 2006-06-07 |
| 1841350196 | Edward Freeman Kirkpatrick Jr. | Dentist | 307 Reed St, Portland, TN 37148-0410 | 2006-12-09 |
| Find all providers in zip 37148 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518573914 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 513-515 Warren Avenue, Portland, ME 04103-1005 | 2020-09-21 |
| 1518473297 | Asterix Eyewear | Eyewear Supplier (Equipment, not the service) | 4936 Se Foster Rd, Portland, OR 97206-3037 | 2017-12-18 |
| 1831616929 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 817 Nw 23rd Ave, Portland, OR 97210-3003 | 2017-08-29 |
| 1568993988 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 9300 Sw Washington Square Rd, Portland, OR 97223-4428 | 2017-03-27 |
| 1063681617 | Oregon Eye Specialists PC | Eyewear Supplier (Equipment, not the service) | 5050 Ne Hoyt St Ste 445, Portland, OR 97213-2984 | 2008-02-28 |
| 1235337890 | Essilor Laboratories of America, Inc | Eyewear Supplier (Equipment, not the service) | 17311 Ne Halsey St, Portland, OR 97230-6025 | 2007-07-05 |
| 1225158496 | Anh Bui | Eyewear Supplier (Equipment, not the service) | 5845 Ne Prescott St, Portland, OR 97218-2231 | 2007-03-30 |
| 1023135670 | Robert M Barton Jr Od | Eyewear Supplier (Equipment, not the service) | 1540 Wildcat Dr, Ste A, Portland, TX 78374-2814 | 2007-03-26 |
| 1831243278 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 513-515 Warren Ave, Portland, ME 04103 | 2007-01-23 |
| 1114076809 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 1260 Lloyd Ctr, Portland, OR 97232-1301 | 2007-01-10 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.