Absalom Blackmon, RKT, LMT,MMP,CPS

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA100038 Issued in FL

Practice address

4822 River Vista LN Apt B
Tampa, FL 33617-7589

Phone

(601) 874-8542

NPI assigned

Jul 10, 2020

Last updated

May 15, 2023By 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 4

Addresses

Electronic endpoints 1

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": "1594339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1407474919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4822 RIVER VISTA LN APT B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336177589",
            "telephone_number": "601-874-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4822 RIVER VISTA LN APT B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336177589",
            "telephone_number": "601-874-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "ABSALOM",
        "name_prefix": "Mr.",
        "credential": "RKT, LMT,MMP,CPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-10",
        "last_updated": "2023-05-15",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IL",
            "license": "227022111",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA100038",
            "primary": true
        },
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "IL",
            "license": "2055",
            "primary": false
        },
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "FL",
            "license": "2055",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "4822 River Vista Ln Apt B",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336177589",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alexis Blackburn
• Julie T Blacker, MS, OTR/L
• Andra Blackheart, LCSW
• Francis E. Blackman, M.D.
• Sandra Gautier Blackman, PA-C
• Brittany Blackmon
• Jovan Deniro Blackmon Jr.
• Maritza Blackshaw, RDH
• Blackstone Medical Services LLC (Blackstone Medical Services)
• Dan Steven Blackwelder, DDS

• Massage Therapist in Tampa, FL
• Providers in Tampa, FL by specialty
• Massage Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.