Terrel Amanda Blackett

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

1261539 Issued in NY

Practice address

1086 E 86TH St
Brooklyn, NY 11236-4243

Phone

(718) 427-1079

Fax

(718) 455-5137

NPI assigned

Nov 3, 2012

Last updated

Nov 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1351900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351900800000",
    "number": "1336493923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1086 E 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364243",
            "telephone_number": "718-427-1079",
            "fax_number": "718-455-5137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1086 E 86TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364243",
            "telephone_number": "718-427-1079",
            "fax_number": "718-455-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKETT",
        "first_name": "TERREL",
        "middle_name": "AMANDA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-03",
        "last_updated": "2012-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NY",
            "license": "1261539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Travis J Blackburn, DPM
• Terry-Jan Blackett-Bonnett, M.D.
• Shatequa Blackett-Robinson, LMSW
• Anna Noble Blackett, CNM
• Kamaria Akilah Blackett, PT
• Indigo Blackford
• Jenny Marie Blackham, MHC-LP
• Alixandra Blackman
• Blair Blackman, LCSW
• Clinette Blackman, LMSW

• Case Manager/Care Coordinator in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Case Manager/Care Coordinator in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2012; 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.