Active NPI
Jessica Blackmon, OT
- Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1700199288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2010007856
- Practice address
- 2865 Netherton Dr
Saint Louis, MO 63136-4674 - Phone
- (314) 653-0918
- NPI assigned
- Jul 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2010007856 | MO | Primary |
Addresses
Primary practice location
2865 Netherton Dr
Saint Louis, MO 63136-4674
Mailing address
2865 Netherton Dr
Saint Louis, MO 63136-4674
Phone (314) 653-0918
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287100800000",
"number": "1700199288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2865 NETHERTON DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631364674",
"telephone_number": "314-653-0918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2865 NETHERTON DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631364674",
"telephone_number": "314-653-0918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "JESSICA",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-26",
"last_updated": "2010-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "2010007856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.