BLACK ROCK VISION CENTER
NPI 1235550146
Optometrist in Reno, NV

Q: What is B. Michael Southam, Od, PC's NPI number?

The NPI number for B. Michael Southam, Od, PC is 1235550146. It was assigned to this organization in the NPPES registry on December 18, 2013. The provider is doing business as Black Rock Vision Center.

Q: What is B. Michael Southam, Od, PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since December 18, 2013

3201 LAKESIDE DR, RENO, NV 89509(775) 825-0559(775) 829-7918 Get Directions Write a Review

NPPES record last updated: December 18, 2013. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Black Rock Vision Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK ROCK VISION CENTER (NPI 1235550146) is a healthcare organization registered as an optometrist in Reno, Nevada and active in the NPI registry since December 2013. The organization lists Brant Michael Southam, Owner/president, as its authorized official.

NPPES Registry Identity

NPI1235550146

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameB. MICHAEL SOUTHAM, OD, PC

Location Address3201 LAKESIDE DRReno, NV 89509-4830

Mailing Address3201 Lakeside DrReno, NV 89509-4830 · (775) 825-0559 · Fax (775) 829-7918

Phone(775) 825-0559

Fax(775) 829-7918

Organization SubpartNo

Authorized OfficialBrant Michael SouthamOwner/president · (775) 825-0559

Enumeration DateDecember 18, 2013

✔ NPI 1235550146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in NV · 779

Definition

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.

3201 LAKESIDE DR, Reno, NV 89509

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Other Names 1

Doing Business AsBlack Rock Vision Center

Other Identifiers 1

Medicaid100533928NV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Black Rock Vision Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 4 clinicians reassign Medicare billing to Black Rock Vision Center, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (4)

Rylee Ziegler, OD

Optometry

NPI 1861273096

3201 LAKESIDE DR
Reno, NV 89509

(775) 825-0559

✔ PECOS✔ Accepts MedicareSame address

Brant Southam, O.D.

Optometry

NPI 1831427160

3201 LAKESIDE DR
Reno, NV 89509

(775) 825-0559

✔ PECOS✔ Accepts MedicareSame address

Corom Eisley, OD

Optometry

NPI 1568957744

2483 WINGFIELD HLS RD STE A100
Sparks, NV 89436

(775) 446-7950

✔ PECOS9.8 mi

Shaune Wallace, OD

Optometry

NPI 1467550335

2210 IDAHO ST
Elko, NV 89801

(775) 738-6727

✔ PECOS✔ Accepts Medicare235 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is B. Michael Southam, Od, PC's NPI number?

The NPI number for B. Michael Southam, Od, PC is 1235550146. It was assigned to this organization in the NPPES registry on December 18, 2013. The provider is doing business as Black Rock Vision Center.

Where is B. Michael Southam, Od, PC located?

B. Michael Southam, Od, PC is located at 3201 Lakeside Dr, Reno, NV 89509. The listed phone number is (775) 825-0559.

What is B. Michael Southam, Od, PC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is B. Michael Southam, Od, PC enrolled in Medicare?

Yes. B. Michael Southam, Od, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through B. Michael Southam, Od, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Optometry, reassign their Medicare billing to B. Michael Southam, Od, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does B. Michael Southam, Od, PC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee list B. Michael Southam, Od, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for B. Michael Southam, Od, PC was last updated on December 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.