DR. KREGG S BLY (NPI# 1679672729) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679672729 |
| Entity Type | Individual |
| Full Name | DR. KREGG S BLY |
| Credential | O.D |
| Practice Address |
5300 Highway 18 W Jackson MS 39209-9411 |
| Practice Telephone | 6019223233 |
| Mailing Telephone | 6019223233 |
| Mailing Fax Number | 6019229225 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2018-12-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 598 | MS | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | AVESIS | 26696 | 01 |
| MS | NVA | 251027 | 01 |
| MS | SPECTERA | 16054 | 01 |
| MS | DAVIS | 42775 | 01 |
| MS | 00880136 | 05 | |
| MS | EYEMED/COLE | MS0598 | 01 |
| Street Address |
5300 HIGHWAY 18 W |
| City | JACKSON |
| State | MS |
| Zip Code | 39209-9411 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548884307 | Bricker B Buseth | Optometrist | 2500 Reynolds Rd, Jackson, MI 49201-9376 | 2020-06-07 |
| 1922667682 | Brittany Renee Bryant | Optometrist | 119 Stonebrook Pl Ste A, Jackson, TN 38305-3636 | 2019-06-06 |
| 1023504818 | Trent Wayne Martin | Optometrist | 1000 Vann Dr Ste A, Jackson, TN 38305-6062 | 2018-07-05 |
| 1417478835 | Mason Ross Womack | Optometrist | 810 Court St # 10, Jackson, CA 95642-2132 | 2017-07-06 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1174923189 | Lindsay Katharine Klumpp | Optometrist | 850 W North St, Ste. 100, Jackson, MI 49202-3196 | 2014-08-27 |
| 1700200227 | Mobile Vision LLC | Optometrist | 1737 Spring Arbor Rd # 164, Jackson, MI 49203-2701 | 2014-02-05 |
| 1831430925 | First Sight LLC | Optometrist | 1316 N State St, Jackson, MS 39202-2003 | 2013-03-14 |
| 1447506381 | Morgan Allyce Strand | Optometrist | 2954 E. Jackson Blvd, Jackson, MO 63755 | 2012-07-30 |
| 1083847776 | The Center for Sight P.C. | Optometrist | 3595 Ann Arbor Rd, Jackson, MI 49202-2703 | 2009-08-27 |
| Find all providers in JACKSON | ||||
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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.