Keith Scott Blackwell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

49 W Broadway Apt 102
Jim Thorpe, PA 18229-1943

Phone

(570) 778-7087

NPI assigned

Jan 30, 2023

Sex

Male

Sole proprietor

No

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

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Star Community Health, Inc

  • General Practice Physician
  • Bethlehem, PA
  • NPI 1033686159
  Medicare reassignment NPD
• Star Community Health, Inc

  • Federally Qualified Health Center (FQHC)
  • Bethlehem, PA
  • NPI 1942832720
  NPD

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1073229258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 W BROADWAY APT 102",
            "city": "JIM THORPE",
            "state": "PA",
            "postal_code": "182291943",
            "telephone_number": "570-778-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 W BROADWAY APT 102",
            "city": "JIM THORPE",
            "state": "PA",
            "postal_code": "182291943",
            "telephone_number": "570-778-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "KEITH",
        "middle_name": "SCOTT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Bleicher, DC
• Kailey Boger
• Dylan Bradley
• Aillinn Brennan, L.P.C.
• Brown & Gobin Incorporated

• Clinical Social Worker in Jim Thorpe, PA
• Providers in Jim Thorpe, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.