Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Blake Allen Peterson, OD

Individual provider Optometrist · NPI 1942200159

Dr. Blake Allen Peterson, OD is an Optometry in Cleveland, Tennessee. Graduated from Southern College of Optometry in 1985, 41 years ago. Practices with Walter F Peterson OD PC, a 3-clinician group and accepts Medicare assignment. Licensed in Tennessee.

Years since qualifying
41
Trained at
Southern College of Optometry
Licensed in
TN
In the registry since
2005
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2020 Keith St NW
Cleveland, TN 37311-1351
Phone: (423) 472-6517
Fax: (423) 476-8578
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence ODT1031 (TN)

Record details

NPI number1942200159
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJuly 29, 2005
Last updated in NPPESDecember 6, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolSOUTHERN COLLEGE OF OPTOMETRY
Graduated 1985 (41 years in practice)
Group practice Walter F Peterson Od Pc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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