Sean Blackwell, AA, PTA LICENSE

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A4690 Issued in MD

Practice address

201 Talbot Blvd Ste W
Chestertown, MD 21620-3000

Phone

(410) 778-3445

NPI assigned

May 6, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Arts

State licenses

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1801470802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 TALBOT BLVD STE W",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203000",
            "telephone_number": "410-778-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TALBOT BLVD STE W",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203000",
            "telephone_number": "410-778-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "SEAN",
        "credential": "AA, PTA LICENSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A4690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sblackwell@cfaortho.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "201 Talbot Blvd Ste W",
            "city": "Chestertown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "216203000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wayne Douglas Benjamin, MD
• Alaka Bhatt-Patel, O.T.
• Lynn Kathleen Bickley, MD
• Bruce M. Blackburn, M.P.T., C.W.S.
• Joanna M. Blackburn, M.P.T., C.L.T.,DSCPT
• Morgan Bleinberger, CRNP
• Megan Marie Blyman, PTA
• Kathryn Bogel
• Carly Boughner
• Sarah E. Boulden, P.T.A.

• All providers in Chestertown, MD
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.