Active NPI
Jessica Blackman
- Occupational Therapist
- Casper, WY
National Provider Identifier
1154724045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1670
- Practice address
- 734 W 19TH St
Casper, WY 82601-4520 - Phone
- (307) 267-5549
- NPI assigned
- Oct 6, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 831 | WY | |
| Occupational Therapist | 225X00000X | 0007595 | CO | |
| Occupational Therapist | 225X00000X | 1670 | WY | Primary |
Addresses
Primary practice location
734 W 19TH St
Casper, WY 82601-4520
Mailing address
734 W 19TH St
Casper, WY 82601-4520
Phone (307) 267-5549
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 |
|---|---|---|---|
| 831 | WY | MD | Occupational Therapy Assistant |
| 0007595 | CO | MD | Occupational Therapist |
| 1670 | WY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663113600000",
"number": "1154724045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "734 W 19TH ST",
"city": "CASPER",
"state": "WY",
"postal_code": "826014520",
"telephone_number": "307-267-5549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "734 W 19TH ST",
"city": "CASPER",
"state": "WY",
"postal_code": "826014520",
"telephone_number": "307-267-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-06",
"last_updated": "2022-09-14",
"certification_date": "2022-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WY",
"license": "831",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CO",
"license": "0007595",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WY",
"license": "1670",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Casper, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.