Samantha Jean Blackburn, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN-153570-M-IV Issued in OH

Practice address

6380 Streams End Dr
Canal Winchester, OH 43110-8241

Phone

(614) 557-1764

NPI assigned

Aug 12, 2013

Last updated

Aug 12, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376265600000",
    "number": "1033542246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6380 STREAMS END DR",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431108241",
            "telephone_number": "614-557-1764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 STREAMS END DR",
            "city": "CANAL WINCHESTER",
            "state": "OH",
            "postal_code": "431108241",
            "telephone_number": "614-557-1764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SAMANTHA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2013-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-153570-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Biller
• Dakota Billings
• Shouvik Biswas, MD
• Melvin Eugene Black II, PHARMD
• Rose Black
• Deborah L Blackwell, D.O.
• Rachielle Blackwell
• Blazing Help LLC
• Blooming Community Health Agency of Columbus
• Lara Blumberg, MD

• Licensed Practical Nurse in Canal Winchester, OH
• Providers in Canal Winchester, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.