Active NPI
Karla Aurora Blackwood, MD
- Psychiatry Physician
- Ann Arbor, MI
National Provider Identifier
1871586719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 4301067633
- Practice address
- 1500 E Medical Center Dr
B1 Floor University Hospital Recp Emergency
Ann Arbor, MI 48109-5020 - Phone
- (734) 996-4747
- NPI assigned
- Aug 25, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 4301067633 | MI | |
| Psychiatry Physician | 2084P0800X | 4301067633 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
B1 Floor University Hospital Recp Emergency
Ann Arbor, MI 48109-5020
Mailing address
3621 S State St
700 KMS Place
Ann Arbor, MI 48108
Phone (734) 936-2047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2608116671 | Other | MI | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chelsea Community Hospital | Psychiatry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1254268800000",
"number": "1871586719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"address_2": "700 KMS PLACE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "48108",
"telephone_number": "734-936-2047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"address_2": "B1 FLOOR UNIVERSITY HOSPITAL RECP EMERGENCY",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095020",
"telephone_number": "734-996-4747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWOOD",
"first_name": "KARLA",
"middle_name": "AURORA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-25",
"last_updated": "2009-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "MI",
"license": "4301067633",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MI",
"license": "4301067633",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "2608116671",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.