MR. BEN D BLACKBURN (NPI# 1932480498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932480498 |
| Entity Type | Individual |
| Full Name | MR. BEN D BLACKBURN |
| Credential | DPH |
| Practice Address |
16657 E 122nd St N Collinsville OK 74021-5180 |
| Mailing Address |
12802 E 96th St N Owasso OK 74055-5371 |
| Practice Telephone | 9186888578 |
| Mailing Telephone | 9182727467 |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-08-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 12179 | OK | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100234240 | 05 | |
| OK | 100234240T | 05 |
| Street Address |
16657 E 122ND ST N |
| City | COLLINSVILLE |
| State | OK |
| Zip Code | 74021-5180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982194254 | Bonnie J Johnston | Registered Nurse | 526 E Center St, Collinsville, OK 74021 | 2018-05-12 |
| 1508218959 | Constance Rogers | Family Medicine | 1205 W Main St, Collinsville, OK 74021 | 2016-07-11 |
| 1922597020 | Catherine Eimer | Case Manager/Care Coordinator | 18492 S View Point Ct, Collinsville, OK 74021-1516 | 2018-05-03 |
| 1982001756 | Julia Profit | Registered Nurse | 215 N 20th St, Collinsville, OK 74021-1604 | 2014-11-21 |
| 1417418666 | Andrea J Caygill | Physician Assistant | 216 N 20th St, Collinsville, OK 74021-1605 | 2019-03-29 |
| 1356452908 | St. John Villas Inc. | Nursing Facility/Intermediate Care Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2006-08-31 |
| 1770113771 | Erika Dawn Rector | Occupational Therapy Assistant | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2020-01-19 |
| 1720506702 | City of Sapulpa | Skilled Nursing Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2017-08-30 |
| 1538400452 | North County Senior Living, LLC | Skilled Nursing Facility | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2013-03-04 |
| 1770828295 | Leslyn Ann Sutton | Occupational Therapy Assistant | 2300 W Broadway St, Collinsville, OK 74021-1625 | 2012-12-10 |
| Find all providers in zip 74021 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730791005 | Kendall Kotter | Pharmacist | 401 Beltline Rd, Collinsville, IL 62234 | 2020-08-18 |
| 1538405451 | Joan M Polwort | Pharmacist | 801 Braidwood Ct, Collinsville, IL 62234 | 2012-12-20 |
| 1942550280 | Adam Turbyfill | Pharmacist | 9155 Hwy 19, Collinsville, MS 39325-0175 | 2012-09-13 |
| 1902154164 | Donnie Joe Scrivner | Pharmacist | 9155 Highway 19 N, Collinsville, MS 39325-9330 | 2012-08-20 |
| 1275818080 | Stephen Scott Branding | Pharmacist | 401 Beltline Rd., Collinsville, IL 62234 | 2011-10-13 |
| 1447534417 | Lindsay Eakin | Pharmacist | 401 Beltline, Collinsville, IL 62234 | 2011-10-07 |
| 1497077184 | Carol O Muzzarelli | Pharmacist | 1101 Belt Line Rd, Collinsville, IL 62234-4368 | 2010-02-22 |
| 1730357906 | Steven Scott Smith | Pharmacist | 29 Hillsborough Dr, Collinsville, IL 62234-6309 | 2008-02-11 |
| 1598366429 | Leann Herschbach | Pharmacist | 1040 Collinsville Crossing Blvd, Collinsville, IL 62234 | 2020-11-06 |
| 1861092363 | Emily Marie Shepherd | Pharmacist | 1101 Belt Line Rd, Collinsville, IL 62234-4368 | 2020-10-26 |
| Find all providers in COLLINSVILLE | ||||
| City | COLLINSVILLE |
| Zip Code | 74021 |
Please comment or provide details below to improve the information on MR. BEN D BLACKBURN.
| 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.