Max Blackburn, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT33346 Issued in FL

Practice address

3350 NW 2ND Ave Ste A6
Boca Raton, FL 33431-6676

Phone

(561) 395-1010

NPI assigned

Jun 14, 2017

Sex

Male

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

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: max.blackburn.1@1366.direct.athenahealth.com

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.

• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141
  Medicare reassignment Care Compare group NPD
• Campbell Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Carthage, TN
  • NPI 1669366068
  NPD

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1598295206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 NW 7TH ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334322625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 NW 2ND AVE STE A6",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334316676",
            "telephone_number": "561-395-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MAX",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-14",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PTT32637",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT33346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Bivins, APRN, FNP-BC
• Emmalyn Hope Bizub
• Jason Daniel Bjalme, DPT
• Jonathan R Black, PSYD
• Blackbird Pharmacy, LLC
• Jennifer Ann Blacklock, PSY.D.
• Leslie Blackman, MA CCC, SLP
• Danielle Marie Blackwell
• Tracy Blad, MA,LMFT
• Jennifer Blair, PSY.D.

• Physical Therapist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.