Individual provider Active NPI

Tommy L Blakeman, M.S.

  • Addiction (Substance Use Disorder) Counselor
  • Plano, TX
National Provider Identifier
1104063742
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6787 Issued in TX
Practice address
2600 Avenue K
Suite
Plano, TX 75074-5306
Phone
(972) 548-5570
Fax
(972) 548-5579
NPI assigned
Jan 20, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6787 TX Primary
Mental Health Counselor 101YM0800X 63187 TX

Addresses

Primary practice location

2600 Avenue K
Suite
Plano, TX 75074-5306

Mailing address

710 Chandler CT
Allen, TX 75002-3617
Phone (972) 548-5570

Other names 1

  • Mr. Tommy L Blakeman Professional name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
63187TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1104063742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 CHANDLER CT",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750023617",
            "telephone_number": "972-548-5570",
            "fax_number": "972-548-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 AVENUE K",
            "address_2": "SUITE",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745306",
            "telephone_number": "972-548-5570",
            "fax_number": "972-548-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "TOMMY",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "6787",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "63187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMMY",
            "last_name": "BLAKEMAN",
            "middle_name": "L",
            "prefix": "MR.",
            "credential": "LPC, LCDC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.