Angela Blackburn, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

44704205566 Issued in MI

Practice address

31208 Day Lily Dr
Brownstown, MI 48173-8768

Phone

(734) 358-0436

NPI assigned

Mar 17, 2017

Last updated

Apr 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ghassan a Atto MD PLLCGroup PAC ID 3870744311, 8 clinicians

Cedar Medical AssociatesGroup PAC ID 9638252687, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020
• Beaumont Hospital - Taylor Hospital, Taylor, MI, CCN 230270

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ablackburn373686@direct.hfhs.org

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.

• Cedar Medical Associates

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1649451964
  Medicare reassignment Care Compare group NPD
• Ghassan a Atto MD PLLC

  • Family Medicine Physician
  • Southgate, MI
  • NPI 1932457546
  Medicare reassignment Care Compare group NPD
• Cedar Medical SNF Services PLLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1194504423
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oakwood Healthcare Inc

  dba Beaumont Outpatient Diabetes Education

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Taylor

  • General Acute Care Hospital
  • Taylor, MI
  • NPI 1487605168
  Care Compare affiliation
• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Dearborn

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1489708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1457892853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31208 DAYLILLY DR",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "48173",
            "telephone_number": "734-358-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31208 DAY LILY DR",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481738768",
            "telephone_number": "734-358-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "ANGELA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-17",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "44704205566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anas Atallah, DPM
• William A. Athens Jr., D.O.
• Nazar Hussain Azad, M.D
• B. a. Burkhart, D. D. S., P.C.
• Jaclyn Taylor Baratono, DO
• Corey Boland, PTA
• Shateria Michelle Boone
• Marley Brereton
• Leanna Bronni, ABOC
• Brown & Brown Consultation Center LLC

• Nurse Practitioner in Brownstown, MI
• Providers in Brownstown, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.