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JACQUELYN TAYLOR BLACKWELL MS
NPI 1194178830
Counselor - Professional in Lake Oswego, OR

Active since July 18, 2016PECOS Enrolled
5285 SW MEADOWS RD, SUITE 170, LAKE OSWEGO, OR 97035(503) 726-5216(503) 726-5218 Get Directions Write a Review

NPPES record last updated: February 9, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 9, 2022, Feb 1, 2022 (2 updates tracked since 2022).

About Jacquelyn Taylor Blackwell Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELYN TAYLOR BLACKWELL MS (NPI 1194178830) is an individual professional provider in Lake Oswego, Oregon, licensed in Oregon (C4984) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1194178830
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameJACQUELYN TAYLOR BLACKWELLCredential: MS
Location Address5285 SW MEADOWS RD, SUITE 170Lake Oswego, OR 97035
Mailing Address5285 Sw Meadows Rd, Suite 170Lake Oswego, OR 97035 · (503) 726-5216 · Fax (503) 726-5218
Phone(503) 726-5216
Fax(503) 726-5218
Sole ProprietorYes
Enumeration DateJuly 18, 2016
Last NPPES UpdateFebruary 9, 20222 updates tracked since enumeration
NPPES CertifiedFebruary 9, 2022
✔ NPI 1194178830 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OR · C4984
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 19-02-02 (OR)
5285 SW MEADOWS RD, Lake Oswego, OR 97035
Open in Google Maps ↗

Other Names 1

Former Name (1)Jacquelyn Taylor Brown

Other Identifiers 1

Medicaid500715046OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacquelyn Taylor Blackwell Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jacquelyn Blackwell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sapphire Blue Behavioral Health Solutions
Same address
Mental Health
5285 MEADOWS RD STE 170
Lake Oswego, OR 97035
  • Reassigned Medicare billing, Oregon enrollment
  • 18 clinicians in this Medicare group
NPI 1558839068 (503) 276-5216

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacquelyn Blackwell's NPI number?

The NPI number for Jacquelyn Blackwell is 1194178830. It was assigned to this individual provider in the NPPES registry on July 18, 2016. The provider is also known as Jacquelyn Taylor Brown.

Where is Jacquelyn Blackwell located?

Jacquelyn Blackwell practices at 5285 SW Meadows Rd Suite 170, Lake Oswego, OR 97035. The listed phone number is (503) 726-5216.

What is Jacquelyn Blackwell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Jacquelyn Blackwell enrolled in Medicare?

Yes. Jacquelyn Blackwell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacquelyn Blackwell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacquelyn Blackwell reassigns Medicare benefits to Sapphire Blue Behavioral Health Solutions (Lake Oswego, OR). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacquelyn Blackwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacquelyn Blackwell accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan and 1 other insurer list Jacquelyn Blackwell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jacquelyn Blackwell was last updated on February 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.