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

Jacob Blackman, OD

Individual provider Optometrist · NPI 1558111575

Jacob Blackman, OD is an Optometry in King, North Carolina. Graduated from Southern College of Optometry in 2024, 2 years ago. Practices with Triad Eye Associates OD PA, a 7-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
2
Trained at
Southern College of Optometry
Licensed in
NC
In the registry since
2024
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

See every abbreviation used in this directory →

Practice location Address checks out

306 Kirby Rd
King, NC 27021-9493
Phone: (336) 983-4313
Fax: (336) 983-3500
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 10564 N Main St Ste E, Archdale, NC 27263-2483 — (336) 434-4033
  • 6425 Old Plank Rd Ste 105, High Point, NC 27265-3277 — (336) 886-7500

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2805 (NC)

Record details

NPI number1558111575
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedMarch 25, 2024
Last updated in NPPESSeptember 3, 2025
Certification dateSeptember 3, 2025
Mailing addressPo Box 4370, Archdale, NC 27263-4370

Medicare enrollment

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

Medicare specialtyOPTOMETRY
Medical schoolSOUTHERN COLLEGE OF OPTOMETRY
Graduated 2024 (2 years in practice)
Group practice Triad Eye Associates Od Pa — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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