Individual provider Active NPI

Terrance Alan Blackwood, D.C.

  • Chiropractor
  • Concordia, KS
National Provider Identifier
1144324294
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-03752 Issued in KS
Practice address
511 Cedar Street
Concordia, KS 66901-2111
Phone
(785) 243-4049
Fax
(785) 243-4735
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Blackwood Chiropractic Clinic P a 2 clinicians

Practice addresses (Care Compare)

511 Cedar St
Concordia, KS 66901-2111
Phone (785) 243-4049

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20050428000962 KS Practitioner - Chiropractic 2062451057 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01-03752KSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Blackwood Chiropractic Clinic P a Chiropractor CurrentSince Jun 29, 1988 Accepting new patients
Blackwood Chiropractic Clinic P a Chiropractor CurrentSince Feb 26, 1993 Accepting new patients

Locations

511 Cedar St
Concordia, KS 66901
Phone (785) 243-4049

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-03752 KS Primary

Addresses

NPPES NPI Registry

Primary practice location

511 Cedar Street
Concordia, KS 66901-2111

Mailing address

P.O. Box 484
Concordia, KS 66901-0484
Phone (785) 243-4049

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144324294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 484",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669010484",
            "telephone_number": "785-243-4049",
            "fax_number": "785-243-4735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 CEDAR STREET",
            "city": "CONCORDIA",
            "state": "KS",
            "postal_code": "669012111",
            "telephone_number": "785-243-4049",
            "fax_number": "785-243-4735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "TERRANCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-03752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concordia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.