Leah Blacktop

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

601 Bridge St
East Jordan, MI 49727-9383

Phone

(231) 536-2206

NPI assigned

Oct 14, 2021

Last updated

Oct 14, 2021By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: leah.blacktop.p1@direct.ejfhc.nextgenshare.com

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1487317764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279383",
            "telephone_number": "231-536-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279383",
            "telephone_number": "231-536-2206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKTOP",
        "first_name": "LEAH",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-14",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851111224",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Access Dental-East Jordan, PC
• Active Recovery Physical Therapy & Sports Rehab
• Robert Fraser Allum, DO
• William B Bice, RPH
• Natalie Bowen
• Courtney Brinkman, NP-C
• Mitchell Carey
• Maegan Chamberlain, LLMSW
• Kathryn Rose Chanda, MA, LLPC

• Clinical Social Worker in East Jordan, MI
• Providers in East Jordan, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.