NPIMap

Organization Active NPI

Jonathan M. Blair PHD, PLLC

  • Psychologist
  • Lansing, MI
National Provider Identifier
1154764827
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301014658 Issued in MI
Legal business name
JONATHAN M. BLAIR PHD, PLLC
Practice address
5123 W St Joe Hwy
Suite 103
Lansing, MI 48917-4093
Phone
(517) 323-4099
NPI assigned
Apr 12, 2013
Last updated
Apr 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Dr. Jonathan Matthew Blair, PHDNPI 1285940064
Title
Licensed Psychologist
Phone
(774) 239-8605

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 6301014658 MI Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 6301014658 MI
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X 6301014658 MI

Addresses

Primary practice location

5123 W St Joe Hwy
Suite 103
Lansing, MI 48917-4093

Mailing address

2909 S Cambridge Rd
Lansing, MI 48911-1024
Phone (774) 239-8605

National Provider Directory

National Provider Directory

Locations

5123 W St Joe Hwy
Ste 103
Lansing, MI 48917
Phone (517) 323-4099

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1154764827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2909 S CAMBRIDGE RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489111024",
            "telephone_number": "774-239-8605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5123 W ST JOE HWY",
            "address_2": "SUITE 103",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489174093",
            "telephone_number": "517-323-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN M. BLAIR PHD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "774-239-8605",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014658",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301014658",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": "MI",
            "license": "6301014658",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.