Active NPI
Rachael Keir Blackman, M.D., PH.D.
- Psychiatry Physician
- Providence, RI
National Provider Identifier
1366822439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- CLP03363
- Practice address
- 345 Blackstone Blvd
Brown University Psychiatry Residency Program
Providence, RI 02906-4800 - Phone
- (401) 455-6375
- NPI assigned
- Jun 4, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | CLP03363 | RI | Primary |
Addresses
Primary practice location
345 Blackstone Blvd
Brown University Psychiatry Residency Program
Providence, RI 02906-4800
Mailing address
345 Blackstone Blvd
Brown University Psychiatry Residency Program
Providence, RI 02906-4800
Phone (401) 455-6375
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)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CLP03363 | RI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Center | Psychiatry | Past | Accepting new patients |
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": "1433376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1366822439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"address_2": "BROWN UNIVERSITY PSYCHIATRY RESIDENCY PROGRAM",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"address_2": "BROWN UNIVERSITY PSYCHIATRY RESIDENCY PROGRAM",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "RACHAEL",
"middle_name": "KEIR",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-04",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "CLP03363",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.