John Blackwell

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

5800 Ownby Dr
Dallas, TX 75205

Phone

(214) 768-5833

NPI assigned

Jul 5, 2018

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

Other identifiers 2

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": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1093201725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5118 HOMER ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752066622",
            "telephone_number": "816-517-8806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 OWNBY DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "214-768-5833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5106 Mayberry St Apt 2201",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681061767",
            "country_code": "US",
            "telephone_number": "816-517-8806",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6001 Dodge St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681821767",
            "country_code": "US",
            "telephone_number": "816-517-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-05",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TDLR",
            "identifier": "AT8826",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "2000038921",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelica Maria Blackwell
• Cassie Lyn Blackwell, FNP
• Christian Blackwell
• Gilbert Chad Blackwell, D.C., D.A.B.C.O., NP
• Isabela Blackwell
• Blaha Family Medical Clinic
• Ronald J Blaha, D.C., RMT, RN
• Ziad Blaik, MD
• Brittany Blair, RN, SRNA
• Dana Moray Blair, CPNP

• Athletic Trainer in Dallas, TX
• Providers in Dallas, TX by specialty
• Athletic Trainer in Texas

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