Sandra Blackburn, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

020836 Issued in OH

Practice address

27991 Center Ridge Rd
Westlake, OH 44145-3902

Phone

(440) 250-0424

NPI assigned

Jun 18, 2017

Last updated

Jun 18, 2017By the provider in NPPES

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

State licenses

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1841720281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 BUNTS RD",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441076106",
            "telephone_number": "440-258-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27991 CENTER RIDGE RD",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441453902",
            "telephone_number": "440-250-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "SANDRA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "020836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birchcrest Holdings, LLC (Pdi Westlake)
• Tonya Lashawn Birney, LPC, LICDC, OCPS II
• Christopher Bishop
• BKD Personal Assistance Services LLC (Brookdale at Home Westlake Village)
• Tina M Black, DO
• Taylor Louise Blackburn, LPCC, MED
• Jay R Blackmur, AA
• Edmond William Blades, MD
• Denisha Eurana Blanchard
• Janice Marie Blau, DO

• Adult Health Nurse Practitioner in Westlake, OH
• Providers in Westlake, OH by specialty
• Adult Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; 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.