Carol Anne Blackmon, RN PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN353197 Issued in CA

Practice address

2525 Grand Ave
Long Beach, CA 90815-1765

Phone

(562) 570-4201

Fax

(562) 570-4099

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801910963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 7TH ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908134504",
            "telephone_number": "562-435-1454",
            "fax_number": "562-435-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 GRAND AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908151765",
            "telephone_number": "562-570-4201",
            "fax_number": "562-570-4099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "CAROL",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "RN PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "RN353197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James M Black, PA
• Mary Ann Black, LCSW
• Pegi Black, NP
• Tracy Black
• Jennifer Ann Blackburn, RN
• Roger Blackshear
• Heather Blackshire
• Antoinette Blackstock, RN
• Rachel E Blaine, DSC, MPH, RDN
• Frank Clarence Blair III, DDS

• Registered Nurse in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.