Jonathan Edward Blacker, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

27023 Issued in CO

Practice address

8000 E Prentice Ave
Suite D-12
Greenwood Village, CO 80111-2744

Phone

(303) 795-3443

Fax

(303) 290-6317

NPI assigned

Feb 16, 2007

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Jonathan Blacker MD

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1063746972
  NPD (past) Authorized official

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263340800000",
    "number": "1477697274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 E PRENTICE AVE",
            "address_2": "SUITE D-12",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112744",
            "telephone_number": "303-795-3443",
            "fax_number": "303-290-6317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 E PRENTICE AVE",
            "address_2": "SUITE D-12",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112744",
            "telephone_number": "303-795-3443",
            "fax_number": "303-290-6317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKER",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2010-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CO",
            "license": "27023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1063746972",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01270230",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44176279",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonita Bird, RN
• James A. Birgenheier Jr., M.D.
• Lara Bishop Teile, RMT, CNMT, MLD
• Julia N Bishop, DO
• Stephanie Bittel, RN
• James Blackford
• Alana Blakeslee, PA-C
• Lizbeth Blanco, RN
• Michelle Bleser, RDH
• Clifford A Bloch, MD

• Otolaryngology Physician in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Otolaryngology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.