Melanie Blackburn

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

1800 Flandro Dr
Pocatello, ID 83202-4912

Phone

(208) 233-2248

NPI assigned

Dec 11, 2023

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

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

{
    "created_epoch": "1702252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1033986054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 ZENER ST APT C6",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832016072",
            "telephone_number": "208-243-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 FLANDRO DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832024912",
            "telephone_number": "208-233-2248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MELANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-11",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walter Kurt Birkenhagen, M.D.
• Jackie Birrer-Atkinson
• Randy Lyman Bishop, M.S.
• Christine E Black, MD
• Robert Grant Black, PT
• Blackrock Counseling
• Blackrock Dental Partners, PLLC
• Carol Blackwell, PHARMD
• Gustin Ross Blad, FNP-BC
• James L Blaine, P.A.-C

• Massage Therapist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Massage Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.