RICKEY ALLEN JR. BLACKBURN (CRNP) – Family Nurse Practitioner, NPI 1841715430

RICKEY ALLEN JR. BLACKBURN (CRNP) is a healthcare provider. based in Evergreen, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-131157 (AL). The NPI Number for RICKEY ALLEN JR. BLACKBURN (CRNP) is 1841715430

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
RICKEY ALLEN JR. BLACKBURN (CRNP)
NPI
1841715430
Phone
(251) 578-2480
Address
101 Crestview Ave
Enumeration Date
4 August 2017
Last Update Date
25 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2515784300
Graduation Year
2015 (11 years ago)
PAC ID
6103242268
Group Practice PAC ID
6305942145
Professional Enrollment ID
I20230925000133
Address ID
AL364013319EV106XXSTXX300

Contacts

Other Endpoint
evergreenmedical.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Other namesUpdated within 12 months

5,653 NURSE PRACTITIONER in AL

Provider Addresses for RICKEY ALLEN JR. BLACKBURN (CRNP)

  • 101 Crestview Ave

    Evergreen, AL 364013333

    Phone: (251) 578-2480

    Type: Location

  • 225 Patterson Ave

    Georgiana, AL 360336628

    Phone: (334) 376-2005

    Type: Location

  • 102 EDWINA ST

    EVERGREEN, AL 364013319

    Phone: (251) 578-0220

    Fax: (251) 578-0223

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $62.

Total Amount is formed as General ($62) + Research ($0) + Ownership ($0) = $62.

Last reported payment date: 2023-09-15 • Largest payer in this snapshot: ATRICURE, INC. ($29).

Total Amount

$62

General + Research + Ownership

Payments

3

Total payment records

General Amount

$62

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-09-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-09-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230925000133INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 36401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305942145View full group profile
NameSpecialtyState
Family PracticeAL
Nurse PractitionerAL
Nurse PractitionerAL
-AL

Reviews

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Frequently asked questions

Does RICKEY ALLEN JR. BLACKBURN (CRNP) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — RICKEY ALLEN JR. BLACKBURN (CRNP) uses 1841715430.
Is RICKEY ALLEN JR. BLACKBURN (CRNP) still practicing?
RICKEY ALLEN JR. BLACKBURN (CRNP) is currently listed as active in the public NPI registry.
What taxonomy line describes RICKEY ALLEN JR. BLACKBURN (CRNP)?
For research purposes, treat RICKEY ALLEN JR. BLACKBURN (CRNP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Does RICKEY ALLEN JR. BLACKBURN (CRNP) list a practice location?
Patients near Evergreen, Alabama may find RICKEY ALLEN JR. BLACKBURN (CRNP) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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