Active NPI
Dean Jay Blackwood, D.C.
- Chiropractor
- Manhattan, KS
National Provider Identifier
1477651990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 01-03921
- Practice address
- 404 Humboldt Street
Suite a
Manhattan, KS 66502-6072 - Phone
- (785) 776-7615
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 01-03921 | KS | Primary |
Addresses
Primary practice location
404 Humboldt Street
Suite a
Manhattan, KS 66502-6072
Mailing address
404 Humboldt Street
Suite a
Manhattan, KS 66502-6072
Phone (785) 776-7615
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01-03921 | KS | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blackwood Chiropractic Clinic P a | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Concordia, KS
- NPI 1366542581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477651990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 HUMBOLDT STREET",
"address_2": "SUITE A",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665026072",
"telephone_number": "785-776-7615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 HUMBOLDT STREET",
"address_2": "SUITE A",
"city": "MANHATTAN",
"state": "KS",
"postal_code": "665026072",
"telephone_number": "785-776-7615"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWOOD",
"first_name": "DEAN",
"middle_name": "JAY",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "01-03921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manhattan, KS
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.