Shayla Marie Blackburn, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043067363 Issued in IL

Practice address

601 Highway 6 W
Iowa City, IA 52246-2209

Phone

(319) 338-0581

Fax

(319) 688-3587

NPI assigned

Sep 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348185600000",
    "number": "1598016107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2708 N COUNTY ROAD 1500",
            "city": "NIOTA",
            "state": "IL",
            "postal_code": "623582112",
            "telephone_number": "217-755-4387",
            "fax_number": "217-755-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "319-338-0581",
            "fax_number": "319-688-3587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SHAYLA",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2012-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043067363",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IA",
            "license": "P28748",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine D Bjornsen, ARNP
• Black & Gold Chiropractic & Wellness LLC
• Andrea Lee Black, RN
• Donald W Black, MD
• Stephanie Broadbent Black, LCSW, LISW
• Jared Nicholas Blad, MD
• Adam Russell Blaine, MD
• Nathan Michael Blair, M.D.
• Robert Alvin Blair, D.D.S.
• William F Blair, M.D.

• Licensed Practical Nurse in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Licensed Practical Nurse in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2012; 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.