Jackie Lynn Blair-Merritt, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3062 Issued in AZ

Practice address

1400 S Dobson Rd
Mesa, AZ 85202-4707

Phone

(480) 512-3627

NPI assigned

Jan 21, 2008

Sex

Female

Sole proprietor

No

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

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Arizona Luna Care Physical Therapy LLCGroup PAC ID 8325469661, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Chandler, AZ
  • NPI 1336770221
  Medicare reassignment NPD
• Lianne Rogers, LLC

  • Physical Therapist
  • Mesa, AZ
  • NPI 1750919098
  Medicare reassignment NPD
• Arizona Luna Care Physical Therapy, LLC

  • Physical Therapist
  • Peoria, AZ
  • NPI 1629698147
  Care Compare group
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1679759682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 E SPRINGFIELD PL",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852861432",
            "telephone_number": "480-857-9597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024707",
            "telephone_number": "480-512-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR-MERRITT",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Wayne Blackburn, MD
• Jared Blacker, DDS
• Davona D Blackhorse, LAC
• Carmen L Blackshear, HOME HEALTH AID
• Maria Elaine Blahut
• Debra Lynn Blair
• Julie Blair, LMSW
• Lindsay Deanna Blaire, M.S., CCC-SLP
• Daniel Stephen Blake, SURGICAL FIRST ASST
• Paul Anthony Blake, MD

• Physical Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.