Individual provider Active NPI

Harold Daniel Blackwood, PHD

  • Clinical Neuropsychologist
  • Phoenix, AZ
National Provider Identifier
1215086137
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
689 Issued in AZ
Practice address
6232 N 7TH St
Ste 100
Phoenix, AZ 85014-1839
Phone
(602) 230-8324
Fax
(602) 274-7402
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 689 AZ Primary

Addresses

Primary practice location

6232 N 7TH St
Ste 100
Phoenix, AZ 85014-1839

Mailing address

6232 N 7TH St
Ste 100
Phoenix, AZ 85014-1839
Phone (602) 230-8324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100211000011 AZ Practitioner - Clinical Psychologist 0648313841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

141 S McCormick St
Suite 109
Prescott, AZ 86303-4703

141 S McCormick St
Suite 109
Prescott, AZ 86303-4730
Phone (928) 777-2407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Neuropsychology Associates PC Clinical Neuropsychologist CurrentSince Nov 1, 1998 Accepting new patients
Neuropsychology Associates P C Clinical Neuropsychologist CurrentSince Nov 1, 1998 Accepting new patients
Neuropsychology Associates, PC Clinical Neuropsychologist Past Accepting new patients

Locations

301 E Bethany Home Rd
Ste A125
Phoenix, AZ 85012
Phone (602) 230-8324

6232 N 7th St
Ste 100
Phoenix, AZ 85014
Phone (602) 230-8324

1515 E Missouri Ave
Ste 110
Phoenix, AZ 85014
Phone (602) 230-8325

141 S McCormick St
Ste 109
Prescott, AZ 86303
Phone (928) 710-8800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1215086137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6232 N 7TH ST",
            "address_2": "STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850141839",
            "telephone_number": "602-230-8324",
            "fax_number": "602-274-7402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6232 N 7TH ST",
            "address_2": "STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850141839",
            "telephone_number": "602-230-8324",
            "fax_number": "602-274-7402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "HAROLD",
        "middle_name": "DANIEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.