Alyssa Blackmore

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

905 Nebraska Ave
Toledo, OH 43607-4222

Phone

(419) 841-7701

NPI assigned

Oct 26, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1790402071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 NEBRASKA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436074222",
            "telephone_number": "419-841-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 NEBRASKA AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436074222",
            "telephone_number": "419-841-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "ALYSSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-26",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106E00000X",
            "taxonomy_group": "",
            "desc": "Assistant Behavior Analyst",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "address_1": "1 S Church Ave Ste 1200",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857011601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sanford Black, M.D.
• Raymond Claude Blackford, DDS
• Kimberly Blackman, QMHS
• Lillyan Blackman
• Harry L Blackmon, LPC
• Charlisa Blackshear
• Delbra A Blackshear
• Justin Jerel Blackshear
• Natalie Blackshear
• Regina Blackshear, QMHS

• Case Manager/Care Coordinator in Toledo, OH
• Providers in Toledo, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.