NPIMap

Organization Active NPI

Blackbird Clinical Services PC

  • Child & Adolescent Psychiatry Physician
  • Allentown, PA
National Provider Identifier
1598524563
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
Legal business name
BLACKBIRD CLINICAL SERVICES PC
Practice address
1247 S Cedar Crest Blvd Ste 107
Allentown, PA 18103-6347
Phone
(484) 202-0751
Fax
(610) 770-1805
NPI assigned
Mar 13, 2024
Last updated
Mar 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Authorized official

Name
Dr. Matthew Keener, MDNPI 1831389873
Title
Chief Medical Officer
Phone
(412) 527-6496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0804X Primary

Addresses

Primary practice location

1247 S Cedar Crest Blvd Ste 107
Allentown, PA 18103-6347

Mailing address

1247 S Cedar Crest Blvd Ste 107
Allentown, PA 18103-6347
Phone (484) 202-0751

National Provider Directory

National Provider Directory

Locations

1247 S Cedar Crest Blvd
Ste 10
Allentown, PA 18103

1247 S Cedar Crest Blvd
Ste 100
Allentown, PA 18103
Phone (610) 770-1800

1247 S Cedar Crest Blvd
Ste 107
Allentown, PA 18103
Phone (484) 202-0751

2003 S Easton Rd
Ste 300
Doylestown, PA 18901

8391 Old Courthouse Rd
Ste 330
Vienna, VA 22182
Phone (703) 239-3470

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1598524563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 S CEDAR CREST BLVD STE 107",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036347",
            "telephone_number": "484-202-0751",
            "fax_number": "610-770-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 S CEDAR CREST BLVD STE 107",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036347",
            "telephone_number": "484-202-0751",
            "fax_number": "610-770-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBIRD CLINICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "KEENER",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "412-527-6496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.