Active NPI
Dustin Lee Blackman, BCTMB, NCP, LMT
- Massage Therapist
- Tuscumbia, AL
National Provider Identifier
1366944167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3081
- Practice address
- 103 W 5TH St
Tuscumbia, AL 35674-2411 - Phone
- (256) 200-9431
- NPI assigned
- Mar 7, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 3081 | AL | Primary |
Addresses
Primary practice location
103 W 5TH St
Tuscumbia, AL 35674-2411
Mailing address
103 W 5TH St
Tuscumbia, AL 35674-2411
Phone (256) 200-9431
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3081 | AL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1366944167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 W 5TH ST",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356742411",
"telephone_number": "256-200-9431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 W 5TH ST",
"city": "TUSCUMBIA",
"state": "AL",
"postal_code": "356742411",
"telephone_number": "256-200-9431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "DUSTIN",
"middle_name": "LEE",
"credential": "BCTMB, NCP, LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "AL",
"license": "3081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tuscumbia, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.