Joseph Kay Blackburn

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5227 Issued in AZ

Practice address

15510 W Bell Rd
Surprise, AZ 85374-3436

Phone

(480) 717-4903

Fax

(480) 717-4904

NPI assigned

Sep 13, 2012

Last updated

Sep 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nextcare Arizona LLC

  dba NextCare Urgent Care

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment
• Peoria Urgent Care and Walk in Clinic PLLC

  • Urgent Care Clinic/Center
  • Peoria, AZ
  • NPI 1093439762
  Medicare reassignment
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD
• Tri-City Express Care, PLLC

  dba FastMed Urgent Care

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1649554940
  NPD
• 4C Medical Group PLC

  dba 4C Urgent Care

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD (past)
• Community Hospital Association, Inc.

  dba Community Hospital Clinic - Wickenburg

  • Rural Health Clinic/Center
  • Wickenburg, AZ
  • NPI 1225274210
  NPD (past)

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1316297740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200",
            "fax_number": "615-425-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853743436",
            "telephone_number": "480-717-4903",
            "fax_number": "480-717-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JOSEPH",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Arizona, LLC (Fresenius Medical Care Sun City West)
• Biren G. Patel, MD, PC
• Alexis Bischof, CNM
• Kimberly Black, LPN
• Trinity V Black
• Stephanie Elizabeth Blackmore, FNP
• Trahsean Blair
• Patricia Joan Blanck-Miller, NP
• Melissa Blevans, RN
• Paige Renae Blom, OD

• Physician Assistant in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.