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Active NPI 1275563694 Individual Practitioner Male Practitioner

Dr. John C. Blackenburg , OD

Optometrist • Selma, AL

Professional Overview & Biography Verified Profile Summary

Dr. John Blackenburg, OD is a registered healthcare professional specializing in Optometrist in Selma, AL. Practice services are available at 700 DALLAS AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

700 Dallas Ave

Selma, AL 367015451

Telephone 8506220364
Fax 8506220364
Associated Practice Facility / Clinic
🏢 Selma Eye Associates, Inc Facility NPI 1730124850

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Selma, AL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 28.0 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
5 Specialists

Practicing in Selma, AL (907 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License AL S498-TA014

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
528200370 (AL)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 700 DALLAS AVE, SELMA, AL 367015451 (Tel: 8506220364)

📍
Updated Business Mailing Address July 08, 2007

Registered at 2080 OLDE TOWNE AVE, MIRAMAR BEACH, FL 325506500 (Tel: 8506220364)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JOHN BLACKENBURG, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist (License #S498-TA014 in AL)

🟢
Initial NPI Registration & Enumeration July 03, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275563694
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2006
Last Update: July 08, 2007
Sole Proprietor: Yes

Mailing Address

2080 Olde Towne Ave

Miramar Beach, FL 325506500

Phone: 8506220364

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.