Active NPI
Carl C Blackwood, CRNA
- Certified Registered Nurse Anesthetist
- Lincoln, NE
National Provider Identifier
1093051989
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 12.005251
- Practice address
- 5701 Lillibridge St Apt 10
Lincoln, NE 68506-3543 - Phone
- (607) 349-9774
- NPI assigned
- Dec 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 12.005251 | CT | Primary |
Addresses
Primary practice location
5701 Lillibridge St Apt 10
Lincoln, NE 68506-3543
Mailing address
5701 Lillibridge St Apt 10
Lincoln, NE 68506-3543
Phone (607) 349-9774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12.005251 | CT | MD | Certified Registered Nurse Anesthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1355961600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355961600000",
"number": "1093051989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5701 LILLIBRIDGE ST APT 10",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685063543",
"telephone_number": "607-349-9774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5701 LILLIBRIDGE ST APT 10",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685063543",
"telephone_number": "607-349-9774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWOOD",
"first_name": "CARL",
"middle_name": "C",
"credential": "CRNA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-12-20",
"last_updated": "2012-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CT",
"license": "12.005251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.