Makayla Blackmer

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

500 S Winmere Ave
Selma, IN 47383-9427

Phone

(765) 748-8328

NPI assigned

Jun 2, 2021

Reactivated

Nov 22, 2022

Last updated

Dec 5, 2022By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jenkinson Co LLC

  • Community Health Worker
  • Selma, IN
  • NPI 1346989993
  NPD Authorized official
• Alphabet Soup ABA, LLC.

  • Behavior Analyst
  • Marion, IN
  • NPI 1437882230
  NPD (past)
• Behavior Associates of Indiana LLC

  • Behavior Analyst
  • Muncie, IN
  • NPI 1679916050
  NPD (past)

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1609442417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S WINMERE AVE",
            "city": "SELMA",
            "state": "IN",
            "postal_code": "473839427",
            "telephone_number": "765-748-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S WINMERE AVE",
            "city": "SELMA",
            "state": "IN",
            "postal_code": "473839427",
            "telephone_number": "765-748-8328"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W Bethel Ave",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473045408",
            "country_code": "US",
            "telephone_number": "765-282-8222",
            "fax_number": "765-282-2820",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "605 N Western Ave",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IN",
            "postal_code": "469523403",
            "country_code": "US",
            "telephone_number": "765-282-8222",
            "fax_number": "765-282-2820",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMER",
        "first_name": "MAKAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-02",
        "last_updated": "2022-12-05",
        "certification_date": "2022-11-28",
        "deactivation_date": "2022-11-15",
        "reactivation_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "IN",
            "license": "RBT-20-114191",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Cook, LCSW
• Jessica Crehan, RD, LD
• Dungarvin Indiana, LLC
• Ryan Evans
• Bobby Boyd Hatfield Jr., PHD, HSPP

• Community Health Worker in Selma, IN
• Providers in Selma, IN by specialty
• Community Health Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2022; 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.