Alfreda Douglane Blackshear, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

40463 Issued in FL

Practice address

1215 Lee Avenue
Tallahassee, FL 32303

Phone

(850) 878-0229

Fax

(850) 942-5837

NPI assigned

Aug 30, 2006

Last updated

May 17, 2013By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alfreda D. Blackshear, M.D.

  • Primary Care Clinic/Center
  • Tallahassee, FL
  • NPI 1861883753
  NPD (past) Authorized official
• Adb Medical Services of N FL LLC

  dba ASK Pediatric Services LLC

  • Pediatrics Physician
  • Tallahassee, FL
  • NPI 1053815431
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1982714507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE AVENUE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "30303",
            "telephone_number": "850-878-0229",
            "fax_number": "850-942-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE AVENUE",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "32303",
            "telephone_number": "850-878-0229",
            "fax_number": "850-942-5837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSHEAR",
        "first_name": "ALFREDA",
        "middle_name": "DOUGLANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "40463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "668737",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Blackburn
• Tricia Blackburn
• Jadae A Blackmon
• Jimmie M Blackmon
• John A Blackmon, M.D.
• Kaydi Blackstock, ATC, LAT
• Christine Jewell Blades, LMT
• Heidi Blair, APRN
• Blair's Counseling Service
• Ashlee Marie Blake, FNP-BC

• Pediatrics Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.