MICHAEL BLACKBURN (NPI# 1225236284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225236284 |
| Entity Type | Individual |
| Full Name | MICHAEL BLACKBURN |
| Credential | RPH |
| Practice Address |
30 Foxmoor Dr Maryville IL 62062-6731 |
| Practice Telephone | 3143430194 |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2008-09-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 2004017958 | MO | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063429652 | Michael Gregory Blackburn | Internal Medicine | 201 15th Ave Sw Ste C, Puyallup, WA 98371-7495 | 2006-08-03 |
| 1649641515 | Michael Blackburn | Audiologist | 4801 Veterans Dr, Saint Cloud, MN 56303-2015 | 2015-10-16 |
| 1619389525 | Michael Alan Blackburn | Family Medicine | 3850 Park Nicollet Blvd, St Louis Park, MN 55416 | 2014-05-27 |
| 1114277662 | Michael Todd Blackburn | Speech-Language Pathologist | 502 4th St Ne, Auburn, WA 98002-5020 | 2012-09-12 |
| 1205057296 | Michael Howard Blackburn | Specialist/Technologist | 210 Sports Dr, Big Rapids, MI 49307-2741 | 2007-05-01 |
| 1114071891 | Michael Blackburn | Counselor | 505 29th St Se, Chartley House, Auburn, WA 98002-7541 | 2007-01-22 |
| 1639134679 | Michael Lowell Blackburn | Physician Assistant | 3480 Yorkshire Medical Park, Lexington, KY 40509-1886 | 2006-04-20 |
| 1538144399 | Michael D Blackburn | Optometrist | 4960 Valleydale Rd, Suite 201, Birmingham, AL 35242-4613 | 2005-12-14 |
| Street Address |
30 FOXMOOR DR |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-6731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| 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 |
|---|---|---|---|---|
| 1912536582 | Andrea Waldrop | Pharmacist | 103 Foothills Mall Drive, Maryville, TN 37801 | 2020-04-06 |
| 1851764922 | Brian T Henderson | Pharmacist | 507 N. Foothills Plaza, Maryville, TN 37801-2312 | 2015-11-11 |
| 1457738023 | Daniel Abercrombie | Pharmacist | 715 Enterprise Way, Maryville, TN 37801-8530 | 2015-05-02 |
| 1548606312 | Emily Abbott | Pharmacist | 104 Hudson St, Maryville, TN 37801-4608 | 2013-05-20 |
| 1912235672 | Amy Maria Hutchens | Pharmacist | 730 Watkins Rd, Maryville, TN 37801-4643 | 2009-11-18 |
| 1790919892 | Mark A. Major | Pharmacist | 945 Mccammon Ave, Maryville, TN 37801-3958 | 2009-05-05 |
| 1346437829 | Michael Edwin Davis | Pharmacist | 624 Hawthorne Dr, Maryville, TN 37803-6316 | 2007-09-28 |
| 1861519688 | Robert Aaron Lucas | Pharmacist | 1607 Loch Leigh Way, Maryville, TN 37801-5803 | 2007-03-25 |
| 1891810511 | Paul Edgar Heird | Pharmacist | 1610 W Broadway Ave, Maryville, TN 37801-5652 | 2007-03-20 |
| 1962558049 | Cynthia Lawson Smith | Pharmacist | 1536 East Broadway Avenue, Lowes Drugs Inc, Maryville, TN 37804-5210 | 2007-01-25 |
| Find all providers in MARYVILLE | ||||
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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.