Active NPI
Trina Blackman
- Adult Care Home Facility
- Detroit, MI
National Provider Identifier
1194577940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Care Home Facility
- Practice address
- 9140 Whittier St Apt 1
Detroit, MI 48224-1846 - Phone
- (586) 209-9385
- NPI assigned
- Apr 4, 2024
- 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 |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | MI | Primary |
Addresses
Primary practice location
9140 Whittier St Apt 1
Detroit, MI 48224-1846
Mailing address
22019 Woodbury St Apt 1
Clinton Township, MI 48035-1766
Phone (586) 209-9385
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": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712188800000",
"number": "1194577940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22019 WOODBURY ST APT 1",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480351766",
"telephone_number": "586-209-9385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9140 WHITTIER ST APT 1",
"city": "DETROIT",
"state": "MI",
"postal_code": "482241846",
"telephone_number": "586-209-9385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "TRINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-04",
"last_updated": "2024-04-04",
"certification_date": "2024-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "311ZA0620X",
"taxonomy_group": "",
"desc": "Custodial Care Facility, Adult Care Home",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.