Tiffany Antoinette Blackmon, APSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

129895-121 Issued in WI

Practice address

5000 W National Ave
Milwaukee, WI 53295-0001

Phone

(414) 384-2000

NPI assigned

Mar 6, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tiffany.blackmon@va.gov

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

{
    "created_epoch": "1614988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1962097410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8951 N PARK PLAZA CT APT 310",
            "city": "BROWN DEER",
            "state": "WI",
            "postal_code": "532232142",
            "telephone_number": "414-698-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W NATIONAL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532950001",
            "telephone_number": "414-384-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "TIFFANY",
        "middle_name": "ANTOINETTE",
        "name_prefix": "Ms.",
        "credential": "APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-06",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "129895-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Tiffany.Blackmon@va.gov",
            "affiliation": "N",
            "endpointDescription": "e-mail address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5000 W National Ave",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532950001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacy Black
• Valerie Black, PA-C
• Lynn A. Blackburn, PH.D.
• Kymberlee A Blackford
• Brittney Blackmon
• David E Blackwelder, PH. D.
• Katherine Elizabeth Blackwell
• Blackwell, LLC
• Lisa Marie Blaeser, LCSW
• Irina A Blagoeva, NP

• All providers in Milwaukee, WI
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.