RICHARD BLACKBURN (NPI# 1356466049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356466049 |
| Entity Type | Individual |
| Full Name | RICHARD BLACKBURN |
| Credential | LADC |
| Practice Address |
1010 E 45th St Shawnee OK 74804-2202 |
| Practice Telephone | 4052731170 |
| Practice Fax Number | 4052755132 |
| Mailing Telephone | 4052731170 |
| Mailing Fax Number | 4052755132 |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
528 | OK | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558467431 | Richard E Blackburn | Psychiatry & Neurology | 2868 Mahan Dr, Suite 5, Tallahassee, FL 32308-5468 | 2006-09-16 |
| 1891215760 | Richard Blackburn | Dentist | 3532 Howard Ave Ste 200, Los Alamitos, CA 90720-3699 | 2017-06-22 |
| 1619227162 | Richard Blackburn | Rehabilitation Practitioner | 1328 2nd St, Santa Monica, CA 90401-1122 | 2012-09-12 |
| 1134293400 | Richard Anthony Blackburn | Psychologist | 1400 N Union Ave, Fergus Falls, MN 56537-1248 | 2006-11-20 |
| 1801834767 | Richard Randall Blackburn | Specialist | 805 6th Ave W Ste 100, Hendersonville, NC 28739-4160 | 2006-06-03 |
| 1275519878 | Richard Jay Blackburn | Family Medicine | 705 Washington St, Ravenswood, WV 26164-1729 | 2005-12-16 |
| Street Address |
1010 E 45TH ST |
| City | SHAWNEE |
| State | OK |
| Zip Code | 74804-2202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144331802 | Gateway To Prevention and Recovery, Inc. | Clinic/Center | 1010 E 45th St, Shawnee, OK 74804-2202 | 2006-08-31 |
| 1669090080 | Francis Payton Johnsom | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-13 |
| 1730706821 | Harrison Blake Hartzell | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2020-07-06 |
| 1992349427 | Dominque Latreace Simmons | Assistant Behavior Analyst | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-10-28 |
| 1215570452 | Rachel Beiermann | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-10-21 |
| 1174179675 | Amber Nichole Randall | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-08-12 |
| 1962962837 | Sydney Reeves | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-25 |
| 1083174353 | Tara Lynn Merritt | Peer Specialist | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-22 |
| 1962962233 | Emalee R Staude | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2019-03-22 |
| 1144704974 | Brooke Anson | Case Manager/Care Coordinator | 1010 E 45th St, Shawnee, OK 74804-2202 | 2018-09-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164063699 | Isaac Benjamin Gray | Student in an Organized Health Care Education/Training Program | 4010 Blaine Road, Shawnee, OK 74804 | 2019-10-06 |
| 1750863775 | Dillon Gibson | Specialist/Technologist | Oklahoma Baptist University, 500 W. University, Shawnee, OK 74804 | 2018-09-06 |
| 1912368242 | Peggy Baker | Occupational Therapist | 7602 N. Kickapoo, Shawnee, OK 74804 | 2016-03-15 |
| 1861731093 | Shariff Mohammed El-assi | Behavioral Analyst | 45 Crown Point, Shawnee, OK 74804 | 2013-02-07 |
| 1902103112 | Action Physical Therapy & Rehabilitation, Pllc | Physical Therapist | 2506 N Harrison, Shawnee, OK 74804 | 2011-02-24 |
| 1639493315 | Oklahoma Em - 1 Medical Services,p.c. | Emergency Medicine | 1102 W.macarthur, Shawnee, OK 74804 | 2010-03-24 |
| 1790989473 | Eastern Oklahoma Radiation Associates, LLC | Radiology | 3700 N Kickapoo Ave Ste 108, Shawnee, OK 74804 | 2007-06-14 |
| 1821210444 | Mickey Sehorn D.d.s., P.C. | Dentist | 1601 Airport Drive, Shawnee, OK 74804 | 2007-05-03 |
| 1760525711 | Leanna Rae Olsen | Registered Nurse | 1500 N. Kickapoo, Suite #4, Shawnee, OK 74804 | 2007-02-15 |
| 1467517920 | Mahmoud Abdel-fattah Khalifa | Pathology | Unity Health Center, 1102 West Macarthur, Shawnee, OK 74804 | 2006-12-26 |
| Find all providers in zip 74804 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598257305 | Kelsey Reye Hamel | Counselor | 12510 W 62nd Ter Ste 109, Shawnee, KS 66216-1869 | 2018-06-06 |
| 1992170013 | Jennifer M Babitzke | Counselor | 12424 W 62nd Ter, Suite A, Shawnee, KS 66216-1810 | 2015-12-01 |
| 1891168050 | Jason Oconnor | Counselor | 9 Quail Rdg, Shawnee, OK 74804-3228 | 2015-11-09 |
| 1164836581 | Sue Jacobson | Counselor | 6221 Richards Dr, Shawnee, KS 66216-1724 | 2014-06-13 |
| 1306262944 | Jane Marie Vogel | Counselor | 5302 Lucille Ln, Shawnee, KS 66203-1455 | 2014-03-06 |
| 1144506684 | Sylvia 'sherry' Charisse Smith | Counselor | 499 Hardesty Dr, Shawnee, OK 74804-1134 | 2011-10-28 |
| 1285832915 | Abigail Maree Cabaniss | Counselor | 1262 Augusta Ct, Shawnee, OK 74801-0500 | 2007-07-03 |
| 1679779987 | David G Lawson | Counselor | 6342 Long Ave, Suite A, Shawnee, KS 66216-2513 | 2007-06-23 |
| 1346366788 | Kellie Dunn | Counselor | 23 E 9th St, Suite 423, Shawnee, OK 74801-6943 | 2007-03-21 |
| 1548399769 | Kevin Jett | Counselor | 26 Father Joe Murphy Dr, Shawnee, OK 74801-8663 | 2007-03-05 |
| Find all providers in SHAWNEE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.