Individual provider Active NPI

Andrew Blackwell

  • Kinesiotherapist
  • Monroe, LA
National Provider Identifier
1528934973
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
KinesiotherapistTaxonomy code 226300000X
License
1978 Issued in LA
Practice address
1691 Bienville Dr
Monroe, LA 71201-3756
Phone
(318) 343-6100
NPI assigned
Oct 14, 2025
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Kinesiotherapist 226300000X 1978 LA Primary

Addresses

Primary practice location

1691 Bienville Dr
Monroe, LA 71201-3756

Mailing address

108 Pecan Grove St
Monroe, LA 71203-3940
Phone (251) 272-6334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1760400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1528934973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 PECAN GROVE ST",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712033940",
            "telephone_number": "251-272-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1691 BIENVILLE DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013756",
            "telephone_number": "318-343-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-10-14",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "LA",
            "license": "1978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.