Samuel Blackie
Individual provider Active NPI Case Management Agency · Farmington, NM
NPI 1487547485 · NPPES record last updated Dec 3, 2025
Key facts
- NPI
- 1487547485
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Agency 251B00000X
- Practice address
- 1001 W Broadway
Farmington, NM 87401-5638 - Phone
- (505) 325-0238
- NPI assigned
- May 30, 2025
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Interoperability endpoints
- samuel.blackie.p1@direct.pmsnm.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | NM | Yes |
Addresses
Primary practice location
1001 W Broadway
Farmington, NM 87401-5638
Mailing address
1001 W Broadway
Farmington, NM 87401-5638
Phone (505) 325-0238
Other providers in Farmington, NM
- Bio-Medical Applications of New Mexico, Inc.
- Wendy D Bircher
- Patricia Faye Bird
- Amylia Ashley Black
- Cameron C. Black
- Taylor Blades
- Ramona A Blagg
- Amber Ruth Blake
- Ernesto Antonio Blanco
- Richard Stanfill Blankenbaker Jr.
All providers in Farmington, NM · Case Management Agency in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.