Kenny R Blackston OD PC
NPI 1710028618 · Optometrist · Andalusia, AL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kenny R Blackston OD PC is a Optometrist organization in Andalusia, AL (NPI 1710028618).
Provider details
- NPI number
- 1710028618
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Stephanie Blackston, Office Manager(334) 222-6325
- License
- S-950-TA-529 (AL)
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Blackston Quality Eye Care
Registry dates
- Enumerated
- 2007-02-12
- Last updated
- 2024-08-26
- Certified
- 2024-08-26
Frequently asked questions
- What is Kenny R Blackston OD PC's NPI number?
- Kenny R Blackston OD PC's National Provider Identifier (NPI) is 1710028618, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kenny R Blackston OD PC?
- Kenny R Blackston OD PC is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Kenny R Blackston OD PC located?
- Kenny R Blackston OD PC's practice location on file with NPPES is 1306 River Falls St, Andalusia, AL 36421-2081.
- What is Kenny R Blackston OD PC's phone number?
- The practice phone number listed in the NPPES registry for Kenny R Blackston OD PC is (334) 222-6325.
- Does Kenny R Blackston OD PC accept Medicare?
- Kenny R Blackston OD PC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kenny R Blackston OD PC?
- The authorized official listed on Kenny R Blackston OD PC's NPPES record is Stephanie Blackston, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kenny R Blackston OD PC's NPI active?
- Yes — Kenny R Blackston OD PC's NPI (1710028618) is active in the NPPES registry as of the last update on 2024-08-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.