Rebecca Jean Blackmore, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

RN2334048 Issued in MA

Practice address

435 Shrewsbury St
Worcester, MA 01604-1689

Phone

(508) 753-5554

NPI assigned

Jul 26, 2024

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

Enrolled in MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Healthcare ServicesGroup PAC ID 3779818828, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Behavioral Healthcare Services

  • Psychiatry Physician
  • Worcester, MA
  • NPI 1346397437
  Medicare reassignment Care Compare group NPD
• Holistic Haven Psychiatry, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, MA
  • NPI 1215878319
  NPD Authorized official

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1902635295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041689",
            "telephone_number": "508-753-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 SHREWSBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041689",
            "telephone_number": "508-753-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "REBECCA",
        "middle_name": "JEAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2334048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johanna D Black
• Sheryl Lubin Black, LICSW
• Timothy Blackburn Jr., LABA
• Neil R Blacklow, M.D.
• Michelle Blackmore
• Anna Blackwell
• Irene F Blair, NP
• Corinne Blake
• Diane R Blake, M.D.
• Travis Blake

• Psychiatric/Mental Health Nurse Practitioner in Worcester, MA
• Providers in Worcester, MA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 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.
• 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.