Blackbird Enterprises, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BLACKBIRD ENTERPRISES, LLC

Doing business as

Allegiance Ambulance

Practice address

422 Champions Dr
Georgetown, TX 78628-1184

Phone

(254) 935-2424

Fax

(903) 887-1863

NPI assigned

Feb 8, 2012

Last updated

Feb 20, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David Phillips

Title

Owner

Phone

(254) 935-2424

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Allegiance Ambulance Doing business as

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

{
    "created_epoch": "1328659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1356613137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2775",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786272775",
            "telephone_number": "254-935-2424",
            "fax_number": "903-887-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 CHAMPIONS DR",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786281184",
            "telephone_number": "254-935-2424",
            "fax_number": "903-887-1863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBIRD ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-08",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-935-2424",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1000781",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegiance Ambulance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alexandra Knudson Bleasdell, FNP-C
• Mary Katherine Bleitner

• Land Ambulance in Georgetown, TX
• Providers in Georgetown, TX by specialty
• Land Ambulance in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.