Blackburn & Whitney MD PS

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BLACKBURN & WHITNEY MD PS

Doing business as

Plastic Surgery Bellingham

Practice address

2500 Squalicum Pkwy BLDG 102
Bellingham, WA 98225-1856

Phone

(360) 676-0972

Fax

(360) 671-4423

NPI assigned

May 10, 2018

Last updated

Sep 24, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

BLACKBURN AND WHITNEY MD PSAs reported in NPPES

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

Authorized official

Name

Timothy M Whitney, MDNPI 1013912351

Title

Co-Medical Director

Phone

(360) 676-0972

Specialties & licenses 4

Addresses

Other names 1

• Plastic Surgery Bellingham Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Blackburn & Whitney MD PS

  • Specialist
  • Bellingham, WA
  • NPI 1144374919

  1456243294

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Blackburn & Whitney MD PS

  • Specialist
  • Bellingham, WA
  • NPI 1144374919

  O20040326000946

  Same enrollment

Listed as

Blackburn and Whitney MD PS Dba Plastic Surgery BellinghamCCN 50C0001326

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Blackburn Whitney MD PS

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Blackburn & Whitney MD PS

  • Specialist
  • Bellingham, WA
  • NPI 1144374919
  NPPES parent name

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Timothy M Whitney, MD

  • Specialist
  • Bellingham, WA
  • NPI 1013912351
  NPD Authorized official
• James H Blackburn II, MD

  • Specialist
  • Bellingham, WA
  • NPI 1952306284
  NPD
• Melissa Ruth Larsen, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Tacoma, WA
  • NPI 1386039154
  NPD

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1881184356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 SQUALICUM PKWY BLDG 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251856",
            "telephone_number": "360-676-0972",
            "fax_number": "360-671-4423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 SQUALICUM PKWY BLDG 102",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251856",
            "telephone_number": "360-676-0972",
            "fax_number": "360-671-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKBURN & WHITNEY MD PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLACKBURN AND WHITNEY MD PS",
        "enumeration_date": "2018-05-10",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO-MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "360-676-0972",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plastic Surgery Bellingham",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Plastic Surgery Bellingham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Anthony Black, L.M.F.T.
• Robert Daryl Black
• Suzanne Elizabeth Black, RN
• Terah Black, PHARMD.
• Blackburn & Whitney MD PS
• James H Blackburn II, MD
• Terri Walker Blackburn, MD
• Linda J. Blackwell, MD
• Lydia Blackwell, LMHC
• Jessica Lynn Blades

• Ambulatory Surgical Clinic/Center in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.