Taylor Renee Blackwell, DNP, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

907045 Issued in MS

Practice address

1314 19TH Ave
Meridian, MS 39301-4116

Phone

(601) 483-0011

NPI assigned

Nov 14, 2022

Last updated

Oct 28, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

River Oaks Management Company LLCGroup PAC ID 0345233110, 35 clinicians

State of Mississippi - University of Mississippi Medical CenterGroup PAC ID 1850293036, 956 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Merit Health River Oaks Hospital, Flowood, MS, CCN 250138
• University of Mississippi Med Center Hospital, Jackson, MS, CCN 250001
• Merit Health River Region Hospital, Vicksburg, MS, CCN 250031

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7115/brand/1/csg/1/fhir/r4
• Direct secure messaging: taylor.blackwell.1@4695.direct.athenahealth.com

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.

• River Oaks Management Company LLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1922029040
  Medicare reassignment Care Compare group NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Medicare reassignment Care Compare group
• Careplus Lakeview Family Medicine

  • Family Medicine Physician
  • Clinton, MS
  • NPI 1942621024
  NPD
• Reservoir Family Medical Clinic, PA

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1770929713
  NPD
• River Oaks Management Company

  dba Comprehensive Weight Management Center

  • Internal Medicine Physician
  • Jackson, MS
  • NPI 1841437654
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• River Oaks Hospital LLC

  dba Merit Health River Oaks

  • General Acute Care Hospital
  • Flowood, MS
  • NPI 1396792032
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1154317527
  Care Compare affiliation
• Vicksburg Healthcare LLC

  dba Merit Health River Region

  • General Acute Care Hospital
  • Vicksburg, MS
  • NPI 1215981303
  Care Compare affiliation

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

{
    "created_epoch": "1668384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1750099305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 HIGHWAY 39 N APT 14B",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393011076",
            "telephone_number": "601-604-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1314 19TH AVE",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393014116",
            "telephone_number": "601-483-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "TAYLOR",
        "middle_name": "RENEE",
        "credential": "DNP, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-14",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MS",
            "license": "907045",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "910231",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William A Billups III, M.D.
• Garrett Black
• Wilmalean Michelle Black, NURSE PRACTITIONER
• Alyse Blackwell, DPT
• John R Blackwell, M.D.
• Kendra Blakely, MS, LPC, NCC
• Amanda Christine Blount, LPC
• Elaine Annette Blount, NP
• Rebecca Blount, NP
• Robert D. Blubaugh, D.O.

• Acute Care Nurse Practitioner in Meridian, MS
• Providers in Meridian, MS by specialty
• Acute Care Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.