Individual provider Active NPI

Steven Allen Blackwell, PH.D., J.D., R.PH.

  • Pharmacist
  • Baltimore, MD
National Provider Identifier
1407960032
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
15124 Issued in MD
Practice address
7500 Security Blvd # C3-20-17
Centers for Medicare & Medicaid Services
Baltimore, MD 21244-1849
Phone
(410) 786-6852
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 15124 MD Primary
Pharmacist 183500000X 6081 TN

Addresses

Primary practice location

7500 Security Blvd # C3-20-17
Centers for Medicare & Medicaid Services
Baltimore, MD 21244-1849

Mailing address

4600 Kings Mill Way
Owings Mills, MD 21117-6601
Phone (443) 394-0591

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
Credentials
Juris Doctor, Doctor of Philosophy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
15124MDMDClinical Social Worker
6081TNMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407960032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 KINGS MILL WAY",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211176601",
            "telephone_number": "443-394-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 SECURITY BLVD # C3-20-17",
            "address_2": "CENTERS FOR MEDICARE & MEDICAID SERVICES",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212441849",
            "telephone_number": "410-786-6852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "STEVEN",
        "middle_name": "ALLEN",
        "credential": "PH.D., J.D., R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "15124",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "6081",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.