Lauren Marie Blackburn, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PTA23795 Issued in FL

Practice address

9051 Tamiami TRL N
Suite 104
Naples, FL 34108-2596

Phone

(239) 591-4711

Fax

(239) 593-1195

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pelican Sports & Rehabilitation of Naples

  • Physical Therapist
  • Naples, FL
  • NPI 1558511725
  NPD (past)
• Pelican Sports and Rehabilitation, Inc

  • Physical Therapist
  • Naples, FL
  • NPI 1437173101
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1851635775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9051 TAMIAMI TRL N",
            "address_2": "SUITE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082596",
            "telephone_number": "239-591-4711",
            "fax_number": "239-593-1195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 TAMIAMI TRL N",
            "address_2": "SUITE 104",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341082596",
            "telephone_number": "239-591-4711",
            "fax_number": "239-593-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "LAUREN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "PTA23795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Bivans, RDN
• Barbara Bixby, ARNP
• Brian Bizzarro, LAT ATC
• Andrica Bjazevic
• Karina M Bjazevic
• Monika Blackmon
• Brian Paul Blaine, PHARMACIST
• Kristin Nicole Blair, DDS
• Jeanne Marie Blake
• Stacey Kathleen Blake, APRN, FNP-C

• Physical Medicine & Rehabilitation Physician in Naples, FL
• Providers in Naples, FL by specialty
• Physical Medicine & Rehabilitation Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.