Elizabeth K Blackwell, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

160261-1205 Issued in UT

Practice address

1750 N Wymount Terrace Dr
Provo, UT 84602-4800

Phone

(801) 422-2771

Fax

(801) 422-0761

NPI assigned

Dec 24, 2007

Sex

Female

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

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: elizabeth.blackwell.1@17226.direct.athenahealth.com

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

{
    "created_epoch": "1198454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1598949786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846024800",
            "telephone_number": "801-422-2771",
            "fax_number": "801-422-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N WYMOUNT TERRACE DR",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846024800",
            "telephone_number": "801-422-2771",
            "fax_number": "801-422-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ELIZABETH",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "160261-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Boyd Black, DMD
• Charlynn Blacker
• Darci Jean Blackett
• Andrea Blackham
• David Maurice Blackwell, PA-C
• Kent Blad, FNP
• Blaine F. Bird, O.D., P.C.
• Chelsea Marie Borup Blair, CSW
• Tarlton J Blair, MD
• Jaren H. Blake, MD

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.