Kenny R Blackston Od PC
NPI 1710028618ActiveOrganization· Optometrist· Andalusia, AL
Optometrist in Andalusia, Alabama, registered in NPPES in February 2007. The authorized official on file is Stephanie Blackston, Office Manager. Enrolled in Medicare as dme supplier - physician - optometrist and part b supplier - clinic/group practice.
Overview
| NPI | 1710028618 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 12, 2007 |
| Last updated in NPPES | Aug 26, 2024 |
| Certified by provider | Aug 26, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | S-950-TA-529 | AL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Optometrist (AL); Part B Supplier - Clinic/Group Practice (AL) |
|---|
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