Allison Blackstock

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA14008 Issued in FL

Practice address

626 N Tyndall Pkwy
Callaway, FL 32404-6132

Phone

(850) 871-6363

NPI assigned

Sep 20, 2016

Sex

Female

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

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": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474329600000",
    "number": "1356899280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N TYNDALL PKWY",
            "city": "CALLAWAY",
            "state": "FL",
            "postal_code": "324046132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 N TYNDALL PKWY",
            "city": "CALLAWAY",
            "state": "FL",
            "postal_code": "324046132",
            "telephone_number": "850-871-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTOCK",
        "first_name": "ALLISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2016-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA14008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 626 N Tyndall Pkwy Opco LLC
• 626 North Tyndall Parkway Operations LLC
• Sylvia Lynn Abercrombie-Broad
• Rebecca Barrett
• Mary Virginia Blue, OTR/L
• Lance Mathew Campbell, DHSC, MSCPT, MTC
• Tammy Carwile Campbell, MA CCC-SLP
• Michelle J Cerbantec, M.S. CCC-SLP
• Cathy Cook Christodoulou, M.S., CCC-SLP

• All providers in Callaway, FL
• Occupational Therapy Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2016; 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.