Active NPI
Isabela Blackwell
- Physician Assistant
- Dallas, TX
National Provider Identifier
1508692492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 6702
- Practice address
- 4055 Valley View LN
Dallas, TX 75244-5074 - Phone
- (855) 984-5121
- NPI assigned
- Sep 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 6702 | CT | Primary |
Addresses
Primary practice location
4055 Valley View LN
Dallas, TX 75244-5074
Mailing address
PO Box 297
Milford, CT 06460-0297
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6702 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Hospital of Central Connecticut at New Britain General and Bradley | Current | Accepting new patients | |
| The Hospital of Central Connecticut at New Britain General and Bradley | Current | Accepting new patients | |
| Midstate Medical Center | Current | Accepting new patients |
Locations
435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340
100 Grand St
New Britain, CT 06052
Phone (860) 224-5011
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Interoperability endpoints
- iblackwell571086@xdr.hhchealthdirect.org
Organizations & group practices 5
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.
-
- Hospitalist Physician
- New Britain, CT
- NPI 1063461481
-
- General Acute Care Hospital
- Meriden, CT
- NPI 1154425288
-
- General Acute Care Hospital
- Meriden, CT
- NPI 1427007848
-
- Psychiatric Hospital Unit
- New Britain, CT
- NPI 1992867006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1508692492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 297",
"city": "MILFORD",
"state": "CT",
"postal_code": "064600297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4055 VALLEY VIEW LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752445074",
"telephone_number": "855-984-5121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "ISABELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CT",
"license": "6702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; 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.