Active NPI
Denise Holly Blackwell, BACHELOR AS
- Private Vehicle
- Binghamton, NY
National Provider Identifier
1003638511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 630288992
- Practice address
- 8 Stanley St
Binghamton, NY 13905-2016 - Phone
- (607) 427-6978
- NPI assigned
- Oct 26, 2024
- Last updated
- Oct 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 630288992 | NY | Primary |
Addresses
Primary practice location
8 Stanley St
Binghamton, NY 13905-2016
Mailing address
8 Stanley St
Binghamton, NY 13905-2016
Phone (607) 427-6978
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Associate of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 630288992 | NY | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729900800000",
"number": "1003638511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 STANLEY ST",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139052016",
"telephone_number": "607-427-6978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8 STANLEY ST",
"city": "BINGHAMTON",
"state": "NY",
"postal_code": "139052016",
"telephone_number": "607-427-6978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "DENISE",
"middle_name": "HOLLY",
"name_prefix": "Miss",
"credential": "BACHELOR AS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-26",
"last_updated": "2024-10-26",
"certification_date": "2024-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "NY",
"license": "630288992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Binghamton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.