Individual provider Active NPI

Jazmine Blackwater

  • Behavior Technician
  • Albuquerque, NM
National Provider Identifier
1245199561
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
5601 Domingo Rd NE
Albuquerque, NM 87108-1610
Phone
(505) 268-5295
Fax
(505) 268-9967
NPI assigned
Jan 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X NM Primary

Addresses

Primary practice location

5601 Domingo Rd NE
Albuquerque, NM 87108-1610

Mailing address

5601 Domingo Rd NE
Albuquerque, NM 87108-1610
Phone (505) 268-5295

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": "1768953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1245199561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 DOMINGO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081610",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 DOMINGO RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871081610",
            "telephone_number": "505-268-5295",
            "fax_number": "505-268-9967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWATER",
        "first_name": "JAZMINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; 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.