Blackmon Chiropractic Clinic, P.a.
Organization Active NPI Chiropractor · Little Rock, AR
NPI 1508850256 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1508850256
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1383 (AR)
- Legal business name
- BLACKMON CHIROPRACTIC CLINIC, P.A.
- Practice address
- 7000 Cantrell Rd
Little Rock, AR 72207-4139 - Phone
- (501) 663-4101
- Fax
- (501) 663-7526
- NPI assigned
- Sep 8, 2005
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher Royse Blackmon, D.C.
- Title
- President
- Phone
- (501) 663-4101
Practitioners 4
-
William Allen Acridge, D.C.
-
Amanda Rae Bledsoe, D.C.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 04D0467473 | Blackmon Chiropractic | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AR
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230221002757 | AR | Part B Supplier - Clinic/Group Practice | 4880643469 |
Receives reassigned benefits from 2 practitioners Practice locations: Little Rock, AR |
National Provider Directory
Locations
7000 Cantrell Rd
Little Rock, AR 72207
Phone (501) 663-4101
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1383 | AR | Yes |
Addresses
Primary practice location
7000 Cantrell Rd
Little Rock, AR 72207-4139
Mailing address
7000 Cantrell Rd
Little Rock, AR 72207-4139
Phone (501) 663-4101
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.