Susan V Blackmore, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

382100 Issued in NY

Practice address

146 Manetto Hill Rd
Plainview, NY 11803-1308

Phone

(516) 931-2200

NPI assigned

Apr 23, 2010

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

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271980800000",
    "number": "1366769820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MANETTO HILL RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031308",
            "telephone_number": "516-931-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MANETTO HILL RD",
            "city": "PLAINVIEW",
            "state": "NY",
            "postal_code": "118031308",
            "telephone_number": "516-931-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "SUSAN",
        "middle_name": "V",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-23",
        "last_updated": "2010-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Alejandra Bianchi Rey, MD
• Charlotte Aronin Birnbaum, M.D.
• Joanne Marie Bisogno
• Jennifer Marie Bjorklund, MSED
• Black Diamond Roslyn, Inc.
• Heather Blank, OPTICIAN
• Robert T Bleck, PH.D.
• Seth Matthew Blum, DDS
• Mara Bochman, RN
• Rachel Bodh

• Pediatric Nurse Practitioner in Plainview, NY
• Providers in Plainview, NY by specialty
• Pediatric Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; 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.