Laura Blackwell

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY003941 Issued in GA

Practice address

5455 Meridian Marks Rd Ste 180
Atlanta, GA 30342-4716

Phone

(404) 785-2849

NPI assigned

Nov 23, 2015

Sex

Female

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

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Children'S BMH Providers, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1144374604
  NPD (past)
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)
• Scottish Rite Childrens Medical Ctr

  • Children's Hospital
  • Atlanta, GA
  • NPI 1922178789
  NPD (past)

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1689048076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 ROSEDALE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303064831",
            "telephone_number": "978-621-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 MERIDIAN MARKS RD STE 180",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424716",
            "telephone_number": "404-785-2849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "LAURA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY003941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Felicia Blackmon
• Lindsay Buechter Blackstock
• Amanda Juliette Blackwell, DPT
• Haley Blackwell
• Keriah Blackwell
• Margaret Anne Blackwell, RN BSN
• Matthew Parker Blackwell, MD
• Trinity Deshay Blackwell
• Temisanren Efua Blagogee, MD
• Emily Blaiklock, PHARMD

• Clinical Neuropsychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.