Suzanne Ravita Blackburn, CRNFA

Primary specialty

Registered Nurse First AssistantTaxonomy code 163WR0006X

License

RN3314902 Issued in FL

Practice address

7897 Saint Andrews Cir
Orlando, FL 32835-8170

Phone

(407) 445-0215

Fax

(407) 445-0287

NPI assigned

Mar 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1801138995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7897 SAINT ANDREWS CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328358170",
            "telephone_number": "407-445-0215",
            "fax_number": "407-445-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7897 SAINT ANDREWS CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328358170",
            "telephone_number": "407-445-0215",
            "fax_number": "407-445-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SUZANNE",
        "middle_name": "RAVITA",
        "credential": "CRNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "FL",
            "license": "RN3314902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310681100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF FLORIDA",
            "identifier": "Y7505",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevin Benjamin Black Jr., MD
• Kianza Stephanie Black
• Lynn Black, RPH
• Tammera Black
• Kaitlyn Mackenzie Blackburn, PTA
• Janee Blackman
• Kaylee Nicole Blackman
• Rachel Blackman
• Shannon Luv Blackmer Robinson, APRN
• Tori Blackshear, BA

• All providers in Orlando, FL
• Registered Nurse First Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.