Jenny T Blackman, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP95005299 Issued in CA

Practice address

3052 Willow Pass Rd
Concord, CA 94519-2552

Phone

(925) 681-4145

NPI assigned

Nov 29, 2016

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Contra Costa County

  • Adult Mental Health Clinic/Center
  • San Pablo, CA
  • NPI 1376620336
  Medicare reassignment NPD
• Contra Costa County

  • Adult Mental Health Clinic/Center
  • Pittsburg, CA
  • NPI 1073691598
  NPD
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1518400183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3052 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192552",
            "telephone_number": "925-681-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3052 WILLOW PASS RD",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945192552",
            "telephone_number": "925-681-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 Mohar Ct",
            "address_purpose": "LOCATION",
            "city": "Pleasant Hill",
            "state": "CA",
            "postal_code": "945235211",
            "country_code": "US",
            "telephone_number": "925-691-6453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "JENNY",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95005299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breanna Bizzle
• Danee K. Black
• Jackson Cole Black
• Katie Nicole Black
• Annette Blackman-Barkan, LMFT
• Alex Blackmon
• Camil Blacksher
• Linda G Blackstone, LCSW MFT
• Chelsey Marie Blackwell
• Jovy Lynn Blackwell

• Primary Care Nurse Practitioner in Concord, CA
• Providers in Concord, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.