Individual provider Active NPI

Erin Vick Blackwell, DPT

  • Physical Therapist
  • Auburn, AL
National Provider Identifier
1952962839
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1-1024 Issued in AL
Practice address
2515 E Glenn Ave Ste 104
Auburn, AL 36830-6448
Phone
(334) 821-2256
Fax
(334) 826-8082
NPI assigned
Jun 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1-1024 AL Primary

Addresses

Primary practice location

2515 E Glenn Ave Ste 104
Auburn, AL 36830-6448

Mailing address

2515 E Glenn Ave
Ste 104
Auburn, AL 36830-6448
Phone (334) 821-2256

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191017002939 AL Practitioner - Physical Therapist in Private Practice 8426389727 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Nova Southeastern Univ College of Dental Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Rehab Solutions LLCGroup PAC ID 8921432485, 2 clinicians
Phenix City Elite Rehab Solutions LLCGroup PAC ID 9335557172, 3 clinicians

Practice addresses (Care Compare)

4 Chambers SQ
Valley, AL 36854-2800
Phone (334) 631-1151

5409 Summerville Rd
Suite 3
Phenix City, AL 36867-7437
Phone (334) 947-1327

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-1024ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Rehab Solutions LLC Physical Therapist CurrentSince May 5, 2020 Accepting new patients
Total Rehab, Inc Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Phenix City Elite Rehab Solutions LLC Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients

Locations

2515 E Glenn Ave
Ste 104
Auburn, AL 36830
Phone (334) 821-2256

5409 Summerville Rd
Ste 3
Phenix City, AL 36867
Phone (334) 297-6721

4 Chambers Sq
Valley, AL 36854
Phone (334) 631-1151

Organizations & group practices 3

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": "1561161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1952962839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 E GLENN AVE",
            "address_2": "STE 104",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306448",
            "telephone_number": "334-821-2256",
            "fax_number": "334-826-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 E GLENN AVE STE 104",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306448",
            "telephone_number": "334-821-2256",
            "fax_number": "334-826-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ERIN",
        "middle_name": "VICK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-22",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "1-1024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; 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.