Teresa Lynn Blackwell, NP

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

AP30007233 Issued in WA

Practice address

3626 NE 45TH St Ste 300
Seattle, WA 98105-5653

Phone

(206) 526-2600

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Teresa Blackwell Myers Former name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Swedish Health Services

  dba Swedish/Issaquah

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465344000000",
    "number": "1053422246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19124 SE 416TH ST",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980229135",
            "telephone_number": "360-802-4848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 NE 45TH ST STE 300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055653",
            "telephone_number": "206-526-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "WA",
            "license": "AP30007233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "MYERS",
            "middle_name": "BLACKWELL",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Craig Blackmore
• Emily Blackmore, RN
• Jacqueline Amara Ellen Blackmore
• Sara Blackmur, MSW, LICSW
• Beth L Blacknall, LMHC
• Katherine Blagden, MSW
• Edward G Blahous Jr., D.P.M.
• Michela Blain, M.D.
• Sarah Kathryn Blaine, MD
• Barbara Jean Blair, ARNP

• Critical Care Neonatal Nurse Practitioner in Seattle, WA
• Providers in Seattle, WA by specialty
• Critical Care Neonatal Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.