Megan Elizabeth Blackburn

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

2024030904 Issued in MO

Practice address

1 Childrens PL
Saint Louis, MO 63110-1002

Phone

(314) 454-6000

NPI assigned

Aug 19, 2024

Last updated

Aug 19, 2024By 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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1891527644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E 3RD ST",
            "city": "TRENTON",
            "state": "IL",
            "postal_code": "622931713",
            "telephone_number": "812-946-3809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MEGAN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "MO",
            "license": "2024030904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mellisa Dawn Black, PMHNP-BC
• Michelle Lynn Jochim Black, PH.D.
• Tdanna Black, MA
• Yolanda Black
• Deborrah Blackburn
• Sally Blackburn, LPC
• Jannah D Blackmon
• Jessica Blackmon, OT
• Kailyn Blackmon, PSYD
• Taiyonna Marshea Lynnese Blackmon, LPN

• Critical Care Neonatal Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Critical Care Neonatal Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.

Verify at the official NPI Registry.