Jennifer Ann Blackburn, PMHNP-C
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Dodge City, KS
NPI 1700643160 · NPPES record last updated Jul 23, 2026
Key facts
- NPI
- 1700643160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 53-84581-051 (KS)
- Practice address
- 2006 1St Ave Ste 602
Dodge City, KS 67801-2623 - Phone
- (620) 253-5789
- NPI assigned
- Mar 4, 2024
- Reactivated
- Jul 23, 2026
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Denver Health and Hospital Authority
Practice addresses (Care Compare)
777 Bannock St
Denver, CO 80204-4507
Phone (303) 436-6000
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-APN.0105700-C-NP | CO | MD | Psychiatric/Mental Health Nurse Practitioner |
| 53-84581-051 | KS | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Kansas Behavioral Health Services | Current |
Accepting new patients |
Locations
2006 1st Ave
Ste 602
Dodge City, KS 67801
Phone (620) 253-5789
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 53-84581-051 | KS | Yes |
Addresses
Primary practice location
2006 1St Ave Ste 602
Dodge City, KS 67801-2623
Mailing address
2006 1St Ave Ste 602
Dodge City, KS 67801-2623
Phone (620) 253-5789
Other providers in Dodge City, KS
- Amanda Belcher
- Kylan Cris Bennett
- Leatha J Benson
- Sheri Lynn Berger
- Christian Bergmeier
- Janese S Boger
- Jamey L Brannon
- Vickie Diane Brass
- David A Brian
- Danny Douglas Briggs Jr.
All providers in Dodge City, KS · Psychiatric/Mental Health Nurse Practitioner in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.