Organization Active NPI

Blackwood Chiropractic Clinic P a

  • Chiropractor
  • Manhattan, KS
National Provider Identifier
1730289190
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLACKWOOD CHIROPRACTIC CLINIC P A
Practice address
404 Humboldt St
Suite a
Manhattan, KS 66502-6072
Phone
(785) 776-7615
NPI assigned
Sep 25, 2006
Last updated
Feb 27, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BLACKWOOD CHIROPRACTIC CLINIC P AAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dean Jay Blackwood, D.C.NPI 1477651990
Title
Owner
Phone
(785) 776-7615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

404 Humboldt St
Suite a
Manhattan, KS 66502-6072

Mailing address

404 Humboldt St
Suite a
Manhattan, KS 66502-6072
Phone (785) 776-7615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050406000464 KS Part B Supplier - Clinic/Group Practice 6103873625 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Concordia, KS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Blackwood Chiropractic Clinic P a

Locations

404 Humboldt St
Ste A
Manhattan, KS 66502
Phone (785) 776-7615

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1730289190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 HUMBOLDT ST",
            "address_2": "SUITE A",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665026072",
            "telephone_number": "785-776-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 HUMBOLDT ST",
            "address_2": "SUITE A",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665026072",
            "telephone_number": "785-776-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKWOOD CHIROPRACTIC CLINIC P A",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLACKWOOD CHIROPRACTIC CLINIC P A",
        "enumeration_date": "2006-09-25",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "BLACKWOOD",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "785-776-7615",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.