Individual provider Active NPI

Tonisha Blackman

  • Licensed Practical Nurse
  • Plymouth, MI
National Provider Identifier
1356283733
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703113460 Issued in MI
Practice address
42360 Ann Arbor Rd E # 120
Plymouth, MI 48170-4303
Phone
(248) 993-5751
NPI assigned
Apr 7, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703113460 MI Primary

Addresses

Primary practice location

42360 Ann Arbor Rd E # 120
Plymouth, MI 48170-4303

Mailing address

42360 Ann Arbor Rd E # 120
Plymouth, MI 48170-4303
Phone (248) 993-5751

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

State licenses

LicenseStateTypeSpecialty
4703113460MIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Consider First Services Current Accepting new patients

Locations

42360 Ann Arbor Rd E
#120
Plymouth, MI 48170
Phone (248) 993-5751

Organizations & group practices 1

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": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1356283733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42360 ANN ARBOR RD E # 120",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704303",
            "telephone_number": "248-993-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42360 ANN ARBOR RD E # 120",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704303",
            "telephone_number": "248-993-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "TONISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703113460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.