Active NPI
Michael Douglas Blackman, CHIROPRACTOR
- Chiropractor
- Cheektowaga, NY
National Provider Identifier
1851471205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- X0029311
- Practice address
- 841 Cleveland Drive
Cheektowaga, NY 14225-1115 - Phone
- (716) 832-2593
- Fax
- (716) 835-3134
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | X0029311 | NY | Primary |
Addresses
Primary practice location
841 Cleveland Drive
Cheektowaga, NY 14225-1115
Mailing address
841 Cleveland Drive
Cheektowaga, NY 14225-1115
Phone (716) 832-2593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120209000073 | NY | Practitioner - Chiropractic | 8527225176 | Practice locations: Cheektowaga, NY |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| X0029311 | NY | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283817600000",
"number": "1851471205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "841 CLEVELAND DRIVE",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251115",
"telephone_number": "716-832-2593",
"fax_number": "716-835-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 CLEVELAND DRIVE",
"city": "CHEEKTOWAGA",
"state": "NY",
"postal_code": "142251115",
"telephone_number": "716-832-2593",
"fax_number": "716-835-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "MICHAEL",
"middle_name": "DOUGLAS",
"name_prefix": "Dr.",
"credential": "CHIROPRACTOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2010-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NY",
"license": "X0029311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cheektowaga, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.