MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1174317697

MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) is a healthcare provider. based in Pittsburg, Kansas. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, PMHNP-BC. They hold a License No. 4704328770 (MI). The NPI Number for MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) is 1174317697

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)
NPI
1174317697
Phone
(620) 240-5668
Address
PO BOX 1832
Enumeration Date
8 April 2025
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2025 (1 year ago)
PAC ID
2567970213
Group Practice PAC ID
7911816392
Professional Enrollment ID
I20250804002397
Address ID
KS667622546PI3015XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:1State licenses:2Digital endpointsOther names

3,550 NURSE PRACTITIONER in KS

Provider Addresses for MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)

  • PO BOX 1832

    PITTSBURG, KS 667621832

    Phone: (620) 240-5668

    Type: Mailing

  • 2100 COMMERCE DR

    PARSONS, KS 673574951

    Phone: (888) 777-9170

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-08-04

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
I20250804002397INurse PractitionerKSTBD

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 66762)

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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: 7911816392View full group profile
NameSpecialtyState
Nurse PractitionerKS
-KS
Pediatric Medicine, Internal Medicine, Pediatric MedicineOH
Nurse PractitionerKS
Nurse PractitionerKS
Physician AssistantKS
Nurse PractitionerKS
Nurse PractitionerKS
-KS
Physician AssistantKS

Reviews

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Frequently asked questions

What is the standard ID for MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) in the U.S.?
In the U.S., MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) is identified by NPI 1174317697.
Does the public listing show MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) as active?
MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)'s NPI record reflects an active status in NPPES.
What services align with MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)'s listing?
MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)'s public classification highlights Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Which community is linked to MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC)?
MRS. STEPHANIE A BLACKBURN (APRN, PMHNP-BC) shows a connection to Pittsburg, Kansas in registry-derived data.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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