Jodi Marie Blacketer, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1132405 Issued in TX

Practice address

6033 W Interstate 20
Arlington, TX 76017-1042

Phone

(817) 483-1746

Fax

(817) 483-5874

NPI assigned

Aug 23, 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 1

Other names 1

• Jodi Marie Boyd Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blacketer Enterprises, IncGroup PAC ID 4981884905, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blacketer Enterprises, Inc

  • Physical Therapy Clinic/Center
  • Arlington, TX
  • NPI 1295046050

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Agape Physical Therapy Services, PC

  • Physical Therapist
  • Brockport, NY
  • NPI 1841200649
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1487761979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746",
            "fax_number": "817-483-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746",
            "fax_number": "817-483-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKETER",
        "first_name": "JODI",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1132405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "1132405",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "BOYD",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Frances Michelle Black-Omari
• Edie Black
• Tonnette Black, NP
• Daniel Joseph Blackaby, D.O.
• Blacketer Enterprises, Inc
• Lisa Blackman, M.S., R.D., L.D
• Treva Blackman, SLP
• Vicki A Blackmon-Davis, M.D.
• Michael Alan Blair, M.D.
• Paris M Blake, LMFT

• Physical Therapist in Arlington, TX
• Providers in Arlington, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.