Kathryn Ann Blackford, CRNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

R047324 Issued in MD

Practice address

711 Maiden Choice LN
Catonsville, MD 21228-3632

Phone

(410) 247-5602

Fax

(410) 242-1756

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 7

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: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1487609590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 MAIDEN CHOICE LN",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212283679",
            "telephone_number": "410-402-2258",
            "fax_number": "410-204-7279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 MAIDEN CHOICE LN",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212283632",
            "telephone_number": "410-247-5602",
            "fax_number": "410-242-1756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKFORD",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MD",
            "license": "R047324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "0943ER-892821-02",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "8304927",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "89282101",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "960702100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-DC",
            "identifier": "T016-000052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "522096682",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "KG01ER-892821-01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Evlyn Esiet Billy-Eko, PMHNP-BC
• Alazar Bitsuamlak, RPH., PHARMD.
• Rosa Maria Bivens, MSW
• Latanya Maroni Black, M.A.
• Kathryn Frances Blackburn, BSN, RN
• Melissa Blake
• Oren Gil Blam, M.D.
• Melissa Mae Blanock, PSY.D.
• Franklin Wayne Blatt, PHARMD
• Blue Sky Therapy & Wellness

• Gerontology Nurse Practitioner in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Gerontology Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.