NPIMap

Individual provider Active NPI

Dushaun Anthony Blackwood, CRNP

  • Nurse Practitioner
  • Allentown, PA
National Provider Identifier
1073294633
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP027796 Issued in PA
Practice address
1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367
Phone
(610) 432-4529
Fax
(610) 432-2206
NPI assigned
Jul 27, 2023
Last updated
Jul 30, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP027796 PA Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367

Mailing address

1230 S Cedar Crest Blvd Ste 302304
Allentown, PA 18103-6367
Phone (610) 432-4529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230823004712 PA Practitioner - Nurse Practitioner 5597128512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Kidney Specialists, P.C.Group PAC ID 2860670734, 31 clinicians

Practice addresses (Care Compare)

1230 S Cedar Crest Blvd
Stes 301 302 and 304
Allentown, PA 18103-6212
Phone (610) 432-4529

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Kidney Specialists, P.C. CurrentSince Apr 20, 2025 Accepting new patients
Valley Kidney Specialists, PC CurrentSince Apr 20, 2025 Accepting new patients
Kidney Care Specialists LLC CurrentSince Jul 17, 2023 Accepting new patients

Locations

1230 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 432-4873

1230 S Cedar Crest Blvd
Ste 302304
Allentown, PA 18103
Phone (610) 402-2537

2000 Sproul Rd
Ste 300
Broomall, PA 19008
Phone (610) 356-3700

1105 Bethlehem Pike
#B5
Sellersville, PA 18960
Phone (215) 257-4533

Interoperability endpoints

  • Direct secure messaging: dblackwood54912@direct.acumenmd.com

Organizations & group practices 4

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

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690675200000",
    "number": "1073294633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 302304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD STE 302304",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "DUSHAUN",
        "middle_name": "ANTHONY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP027796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.