Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole P Blackburn

Individual provider Physical Therapist · NPI 1134902471

Nicole P Blackburn is a Physical Therapist in Private Practice in Honolulu, Hawaii. Qualified in 2023, 3 years ago. Practices with Jaco Rehab Honolulu Limited Partnership, a 21-clinician group and accepts Medicare assignment. Licensed in Hawaii.

Years since qualifying
3
Licensed in
HI
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1401 S Beretania St Ste 550
Honolulu, HI 96814-1880
Phone: (808) 381-3947
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT-5778 (HI)

Record details

NPI number1134902471
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 18, 2023
Last updated in NPPESAugust 18, 2023
Certification dateAugust 18, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Jaco Rehab Honolulu Limited Partnership — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Honolulu