Angela Blackburn

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0131001582 Issued in VA

Practice address

1030 Loftis Blvd Ste 103
Newport News, VA 23606-2999

Phone

(757) 720-0099

NPI assigned

Jan 8, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Autism Therapeutic Services

  dba HealthPRO Pediatrics

  • Behavior Analyst
  • Fayetteville, NC
  • NPI 1598067449
  NPD (past)

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1689444978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "568 SANDHURST DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044426",
            "telephone_number": "910-484-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 LOFTIS BLVD STE 103",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236062999",
            "telephone_number": "757-720-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "ANGELA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131001582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Bivins
• Black Angels Home Health Care LLC
• Black Couch Therapy LLC
• Black Pine Counseling Center (Black Pine Counseling)
• Kelsey Elizabeth Black, OTR/L
• Melaina A'Lynn Blackford, PT, DPT
• Caitlin Blackwell
• Ronald T. Blade, LPC
• Elina Blaha, O.D.
• Ashley Madison Blair

• Occupational Therapy Assistant in Newport News, VA
• Providers in Newport News, VA by specialty
• Occupational Therapy Assistant in Virginia

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