KAILYN BLACKMON (PSYD) – Clinical Psychologist, NPI 1447014774

KAILYN BLACKMON (PSYD) is a healthcare provider. based in Saint louis, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 124232 (IA). The NPI Number for KAILYN BLACKMON (PSYD) is 1447014774

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
KAILYN BLACKMON (PSYD)
NPI
1447014774
Phone
Not provided
Address
1 JEFFERSON BARRACKS RD
Enumeration Date
7 February 2024
Last Update Date
7 February 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2020 (6 years ago)
PAC ID
0143709725
Group Practice PAC ID
8022264696
Professional Enrollment ID
I20260204003778
Address ID
GA301527701KE4307XNWXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

Provider Addresses for KAILYN BLACKMON (PSYD)

  • 1 JEFFERSON BARRACKS RD

    SAINT LOUIS, MO 631254181

    Phone:

    Mailing address matches the actual address.

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: 2026-02-04

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
I20260204003778IClinical PsychologistGATBD

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 63125)

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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: 8022264696View full group profile
NameSpecialtyState
Nurse PractitionerGA
Clinical Social WorkerGA
Mental Health CounselorGA
Marriage And Family TherapistGA
Clinical PsychologistGA
Clinical PsychologistGA
Marriage And Family TherapistGA
Mental Health CounselorOR
Mental Health CounselorGA
Clinical PsychologistGA

Reviews

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Frequently asked questions

Is there an official ID for KAILYN BLACKMON (PSYD) in U.S. healthcare records?
The official identifier for KAILYN BLACKMON (PSYD) is NPI 1447014774.
Is KAILYN BLACKMON (PSYD) shown as active in public data?
Registry records indicate KAILYN BLACKMON (PSYD) maintains an active NPI.
How would a patient describe KAILYN BLACKMON (PSYD)'s focus?
For KAILYN BLACKMON (PSYD), the primary taxonomy reads as Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where in Missouri is KAILYN BLACKMON (PSYD) registered?
Use Saint Louis, Missouri as the headline location for KAILYN BLACKMON (PSYD) here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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