Jason Blackburn, C.P.S.S.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1901 Westbank Expy
Suite 550
Harvey, LA 70058-4366

Phone

(504) 247-9120

Fax

(504) 247-9125

NPI assigned

Dec 8, 2016

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• Resources for Human Development

  • Community/Behavioral Health Agency
  • Harvey, LA
  • NPI 1790940013
  NPD (past)

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1669916797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 WESTBANK EXPY",
            "address_2": "SUITE 550",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700584366",
            "telephone_number": "504-247-9120",
            "fax_number": "504-247-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WESTBANK EXPY",
            "address_2": "SUITE 550",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700584366",
            "telephone_number": "504-247-9120",
            "fax_number": "504-247-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JASON",
        "credential": "C.P.S.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-08",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Harvey, LA
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; 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.