Earnest Howard-Rudolph Blackshear Jr., PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0864 Issued in NV

Practice address

5836 Beluga Bay St
North Las Vegas, NV 89081-6843

Phone

(702) 941-0583

Fax

(702) 832-1940

NPI assigned

Feb 5, 2009

Last updated

Mar 28, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Battle-Born Psychological Services, LLC

  • Clinical Psychologist
  • North Las Vegas, NV
  • NPI 1912377482
  NPD Authorized official
• J H Daulat DO PC

  dba Mohave Dermatology

  • Dermatology Physician
  • Las Vegas, NV
  • NPI 1194268987
  NPD (past)

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

{
    "created_epoch": "1233792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1386883932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5836 BELUGA BAY ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816843",
            "telephone_number": "702-941-0583",
            "fax_number": "702-832-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5836 BELUGA BAY ST",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890816843",
            "telephone_number": "702-941-0583",
            "fax_number": "702-832-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSHEAR",
        "first_name": "EARNEST",
        "middle_name": "HOWARD-RUDOLPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-05",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Battle-Born.Psych.Svcs@outlook.com",
            "affiliation": "N",
            "endpointDescription": "Secured Business Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5836 Beluga Bay St",
            "city": "North Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890816843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura Bjork
• Erik Bjorndal
• Angelia Michelle Black
• Patricia Black
• William Raymond Black
• Phoenyx Blacksnow, LCSW
• Jessica Rae Blackwell, RKT
• Justin Lavonte Blagmon
• Carla L Blair, PA-C
• Blairs House LLC

• Clinical Psychologist in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.