Jared Christian Blakely

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

18-57505 Issued in FL

Practice address

2431 Creighton Rd
Pensacola, FL 32504-7337

Phone

(850) 607-6910

Fax

(850) 607-6932

NPI assigned

Jul 18, 2018

Last updated

Jul 18, 2018By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1538645064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 STEFANI RD",
            "city": "CANTONMENT",
            "state": "FL",
            "postal_code": "325337795",
            "telephone_number": "850-607-6910",
            "fax_number": "850-607-6932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 CREIGHTON RD",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325047337",
            "telephone_number": "850-607-6910",
            "fax_number": "850-607-6932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "JARED",
        "middle_name": "CHRISTIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-18",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "18-57505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacia Blackmon
• Meagan Katherine Blades, PA
• Matthew Lewis Blair, D.O.
• Ashley Harris Blake, LPN
• McKenzie Blake
• Michelle L Blakeney
• Geneva G Blanchard, ARNP
• Heather Blanchard
• Nolan James Blanchard, MD
• William B. Blanchard, MD

• Behavior Technician in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Behavior Technician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.