Leasa Lasae Blackmon, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

221219 Issued in GA

Practice address

240 Mitchell Bridge Rd
Athens, GA 30606-2043

Phone

(770) 910-9196

Fax

(678) 682-8747

NPI assigned

Apr 24, 2024

Last updated

Apr 24, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1689420424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490182",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300490004",
            "telephone_number": "470-232-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MITCHELL BRIDGE RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062043",
            "telephone_number": "770-910-9196",
            "fax_number": "678-682-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "LEASA",
        "middle_name": "LASAE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "GA",
            "license": "221219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Bishop
• Elizabeth Jennings Bishop, LCSW
• Michael S Biswas, MD
• Rachel Kay Black
• Daphne Lorraine Blackburn, M.D.
• Cydney Blackwell, PHARM D
• Ophelia Marlene Blackwell, PHD, LCPC, LPC, NCC
• Daniel Blair, DO, FACP
• Diana T Blake, MD
• Rashay Blake, MSW

• Psychiatric/Mental Health Registered Nurse in Athens, GA
• Providers in Athens, GA by specialty
• Psychiatric/Mental Health Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.