Alaric Remington Lane Blackwell, CSA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

1204754 Issued in KY

Practice address

PO Box 64
Florence, KY 41022-0064

Phone

(859) 957-9975

NPI assigned

May 24, 2022

Sex

Male

Sole proprietor

Yes

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)

Enrolled

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1659019248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410220064",
            "telephone_number": "859-957-9975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 64",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "410220064",
            "telephone_number": "859-957-9975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ALARIC",
        "middle_name": "REMINGTON LANE",
        "credential": "CSA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-24",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": "1204754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessie C Bittner, D.M.D
• Deborah Domal Black, PT
• Kristin Black
• Shawn Black, PT
• Sydney K. Black
• Vora Onique Blake, LPCC-S
• Joshua T Blancher, APRN
• Jared Allen Blank, DPT
• Brett Blevins, BCBA
• Sydney Paige Blevins, BA

• Case Manager/Care Coordinator in Florence, KY
• Providers in Florence, KY by specialty
• Case Manager/Care Coordinator in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.