Tre Alan Blackford, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

101467 Issued in IA

Practice address

701 Riverview St
Des Moines, IA 50316-2343

Phone

(515) 266-1106

NPI assigned

Feb 19, 2021

Sex

Male

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

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": "1613692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1467045484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9816 LAGUNA DR",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312998",
            "telephone_number": "641-751-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 RIVERVIEW ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503162343",
            "telephone_number": "515-266-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKFORD",
        "first_name": "TRE",
        "middle_name": "ALAN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-19",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "101467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Messan Blabuh, MLS
• Chelsea Black, LMHC
• Rodney Black, MSW
• Lindsay Yasmin Blackford, LMSW
• Timothy John Blackford, RPH
• Akaisha Safa'E Blackhawk, LMSW
• Michael Blaess, DO
• Rebecca Ann Blair Manges, ARNP
• Jaime Blair
• Jonathan David Blair, RN

• Physical Therapist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.