Active NPI
Sherita Blackburn
- Community/Behavioral Health Agency
- Pittsburgh, PA
National Provider Identifier
1114389731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Practice address
- 1505 Summerdale St
Pittsburgh, PA 15204-1130 - Phone
- (412) 586-8548
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
1505 Summerdale St
Pittsburgh, PA 15204-1130
Mailing address
1505 Summerdale St
Pittsburgh, PA 15204-1130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1026148700002 | Medicaid | PA |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458691200000",
"number": "1114389731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1505 SUMMERDALE ST",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152041130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1505 SUMMERDALE ST",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152041130",
"telephone_number": "412-586-8548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "SHERITA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-23",
"last_updated": "2016-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1026148700002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pittsburgh, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.