Active NPI
Brandon Blackburn
- Case Manager/Care Coordinator
- Joplin, MO
National Provider Identifier
1659772416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 3230 Wisconsin Ave
Joplin, MO 64804-4029 - Phone
- (417) 347-7580
- Fax
- (417) 347-0293
- NPI assigned
- Sep 11, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
3230 Wisconsin Ave
Joplin, MO 64804-4029
Mailing address
PO Box 2526
Joplin, MO 64803-2526
Phone (417) 347-7579
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410393600000",
"number": "1659772416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2526",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648032526",
"telephone_number": "417-347-7579",
"fax_number": "417-347-0293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3230 WISCONSIN AVE",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648044029",
"telephone_number": "417-347-7580",
"fax_number": "417-347-0293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-09-11",
"last_updated": "2014-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.