Active NPI
Jerrica Blackburn
- Personal Care Attendant
- Omaha, NE
National Provider Identifier
1598653172
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Personal Care Attendant
- Practice address
- 6003 Ville Desante Dr
Omaha, NE 68104 - Phone
- (402) 306-9071
- NPI assigned
- Jun 24, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Primary | ||
| Chore Provider | 372500000X |
Addresses
Primary practice location
6003 Ville Desante Dr
Omaha, NE 68104
Mailing address
7200 S 84TH St
La Vista, NE 68128-2115
Phone (531) 600-8009
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": "1750723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1598653172",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7200 S 84TH ST",
"city": "LA VISTA",
"state": "NE",
"postal_code": "681282115",
"telephone_number": "531-600-8009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6003 VILLE DESANTE DR",
"city": "OMAHA",
"state": "NE",
"postal_code": "68104",
"telephone_number": "402-306-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "JERRICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-06-24",
"last_updated": "2025-06-24",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "3747P1801X",
"taxonomy_group": "",
"desc": "Technician, Personal Care Attendant",
"state": null,
"license": null,
"primary": true
},
{
"code": "372500000X",
"taxonomy_group": "",
"desc": "Chore Provider",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.