CARESSA BLACKMAN, CTRS — NPI 1396367405 (Licensed & Credentialed Recreation Therapist in CADDO MILLS, TX)

CMS-1500 Box 24J / 33a • NPI

1396367405

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

225800000X

Licensed & Credentialed Recreation Therapist

Box 32 Service Location & ZIP+4

4820 CHRISTIE AVE, CADDO MILLS, TX, 75135

Official NPPES Practice Location

Practice Phone & Referral Fax

(843) 476-3460

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1396367405 (CARESSA BLACKMAN, CTRS) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1396367405` (NPI-1 Individual Practitioner)
Provider / Legal Name	CARESSA BLACKMAN, CTRS
Plain-English Specialty	Licensed & Credentialed Recreation Therapist NUCC Code: `225800000X` (Recreation Therapist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	4820 CHRISTIE AVE, CADDO MILLS, TX, 75135
Practice Telephone / Fax	Tel: (843) 476-3460
Administrative Mailing Address	1201 E 9TH ST, BONHAM, TX, 75418-4059
Enumeration & Last Sync	Enumerated: 2020-05-12 \| CMS Record Updated: 2021-09-22

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

4820 CHRISTIE AVE, CADDO MILLS, TX, 75135

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Plain-English Taxonomy & CMS Crosswalk (225800000X)

What Does Taxonomy Code 225800000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225800000X translates to:
"Licensed & Credentialed Recreation Therapist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Recreation Therapist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (CARESSA BLACKMAN, CTRS)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225800000X` — Recreation Therapist Plain English: Licensed & Credentialed Recreation Therapist	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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CARESSA BLACKMAN, CTRS (NPI #1396367405)