Ann Marie Blacktop, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

AB033570 Issued in MI

Practice address

611 E Main St
Hart, MI 49420-1190

Phone

(231) 873-5675

Fax

(231) 873-4805

NPI assigned

Jul 5, 2006

Last updated

May 22, 2009By 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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Health Partners

  dba Trinity Health Medical Group

  • Certified Registered Nurse Anesthetist
  • Shelby, MI
  • NPI 1154910172
  NPD
• Mercy Health Partners

  dba Trinity Health Medical Group Primary Care Hart

  • Rural Health Clinic/Center
  • Hart, MI
  • NPI 1518383025
  NPD

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1689605230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E MAIN ST",
            "city": "HART",
            "state": "MI",
            "postal_code": "494201190",
            "telephone_number": "231-873-5675",
            "fax_number": "231-873-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E MAIN ST",
            "city": "HART",
            "state": "MI",
            "postal_code": "494201190",
            "telephone_number": "231-873-5675",
            "fax_number": "231-873-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKTOP",
        "first_name": "ANN",
        "middle_name": "MARIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "AB033570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMI",
            "identifier": "800F410320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8008974220",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "383119096",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Babbin, COTA
• Kaitlyn Elizabeth Bacon, PT, DPT
• Marlene Marie Berens, DNP
• Jessica Bernhardt, RDH
• Kala Bieniek, PHARM. D.
• Melissa Borgman, LPTA
• Cheryl Bowen
• Fred Clifford Bowen III
• Douglas S. Brown, D.C.
• Marstie Sue Bunting, D-NP

• Clinical Social Worker in Hart, MI
• Providers in Hart, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.