Active NPI
Jo Ann Blacckwell
- Registered Nurse
- Houston, TX
National Provider Identifier
1669070496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 463904
- Practice address
- 2424 Wilcrest Dr Ste 110
Houston, TX 77042-2772 - Phone
- (713) 666-8287
- NPI assigned
- Oct 14, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 463904 | TX | Primary |
Addresses
Primary practice location
2424 Wilcrest Dr Ste 110
Houston, TX 77042-2772
Mailing address
3927 Carters Lake Dr
Richmond, TX 77406-6973
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 463904 | TX | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602633600000",
"number": "1669070496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3927 CARTERS LAKE DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774066973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2424 WILCREST DR STE 110",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770422772",
"telephone_number": "713-666-8287"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACCKWELL",
"first_name": "JO ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-14",
"last_updated": "2020-10-14",
"certification_date": "2020-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TX",
"license": "463904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.