William Blackburn, MS

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7785 Issued in LA

Practice address

648 Crestwood Blvd
Covington, LA 70433-8261

Phone

(985) 805-2555

NPI assigned

Aug 9, 2019

Last updated

Aug 9, 2019By 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

Master of Science

Practice roles

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.

• Informed Dysphagia Diagnostics LLC

  • Speech-Language Pathologist
  • Hammond, LA
  • NPI 1336747237
  NPD Authorized official

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1447805064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 CRESTWOOD BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 CRESTWOOD BLVD",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338261",
            "telephone_number": "985-805-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "WILLIAM",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "7785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "ewells@neurocovery.com",
            "affiliation": "N",
            "address_1": "648 Crestwood Blvd",
            "city": "Covington",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704338261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of Louisiana, LLC (Pontchartrain Kidney Center)
• Sara Grace Birch, MS, RDN, LDN
• Lori Bischoff
• Camille Nasim Bitar, M.D.
• Bitars Specialty Clinic, LLC
• Crystal Blackledge
• Amanda E Blair, LCSW
• Alli Beth Blanchard, DDS
• Susan H Blanchard, PT
• Blake Thomas Blancher, MD

• Speech-Language Pathologist in Covington, LA
• Providers in Covington, LA by specialty
• Speech-Language Pathologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.