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BRENT PATRICK BLACKWELL
NPI 1275282188
Student in an Organized Health Care Education/Training Program in Las Vegas, NV

Active since March 20, 2022PECOS Enrolled
1701 W CHARLESTON BLVD STE 490, LAS VEGAS, NV 89102(702) 671-2273 Get Directions Write a Review

NPPES record last updated: March 20, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Brent Patrick Blackwell NPPES

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

BRENT PATRICK BLACKWELL (NPI 1275282188) is an individual student in an organized health care education/training program in Las Vegas, Nevada and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275282188
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameBRENT PATRICK BLACKWELL
Location Address1701 W CHARLESTON BLVD STE 490Las Vegas, NV 89102-2309
Mailing Address1701 W Charleston Blvd Ste 490Las Vegas, NV 89102-2309
Phone(702) 671-2273
Sole ProprietorNo
Enumeration DateMarch 20, 2022
NPPES CertifiedMarch 20, 2022
✔ NPI 1275282188 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1701 W CHARLESTON BLVD STE 490, Las Vegas, NV 89102
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Brent Patrick Blackwell 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.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIFFANY ZEN YU MD
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-2273
NATHAN JON LLOYD MD
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-6474
MARY FROEHLICH
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-2273
NATALIE DEMIRJIAN
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-6474
JORDAN TIAN NICHOLS MD
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-2273
KENNY HOANG DO
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-6474
EMILY SUSAN SAGALOW
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-6474
NICHOLAS ALASTAIR LIU
Student in an Organized Health Care Education/Training Program
1701 W CHARLESTON BLVD STE 490
LAS VEGAS, NV 89102
Clark County (702) 671-2273

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 Brent Blackwell's NPI number?

The NPI number for Brent Blackwell is 1275282188. It was assigned to this individual provider in the NPPES registry on March 20, 2022.

Where is Brent Blackwell located?

Brent Blackwell practices at 1701 W Charleston Blvd Ste 490, Las Vegas, NV 89102. The listed phone number is (702) 671-2273.

What is Brent Blackwell's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Brent Blackwell enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Brent Blackwell was last updated on March 20, 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.