JEFFREY M BLACKMON (NPI# 1710901996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710901996 |
| Entity Type | Individual |
| Full Name | JEFFREY M BLACKMON |
| Credential | M.D. |
| Practice Address |
420 E 2nd Ave Suite 103 Rome GA 30161-3224 |
| Mailing Address |
304 Turner Mccall Blvd Sw Rome GA 30165-5621 |
| Practice Telephone | 7065093278 |
| Practice Fax Number | 7065094608 |
| Mailing Telephone | 7065096122 |
| Mailing Fax Number | 7065094608 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 055917 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619469830 | Jeffrey Blackmon Blackmon | Counselor | 3450 Highway 80 W, Jackson, MS 39209 | 2018-06-04 |
| Street Address |
420 E 2ND AVE SUITE 103 |
| City | ROME |
| State | GA |
| Zip Code | 30161-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699721399 | Floyd Healthcare Management Inc | Hospice Care, Community Based | 420 E 2nd Ave, Suite 105, Rome, GA 30161-3209 | 2006-05-25 |
| 1477915569 | Farrah Gardner | Nurse Practitioner | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2016-03-28 |
| 1134588916 | Julie White | Nurse Practitioner | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2016-02-22 |
| 1417281999 | Lee Caroline Duvall | Nurse Practitioner | 420 E 2nd Ave, Rome, GA 30161-3209 | 2009-09-30 |
| 1851508964 | Jonathan Garrett Gore | Emergency Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2007-05-17 |
| 1356562185 | Cline Thomas Jackson | Emergency Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2007-05-01 |
| 1316003197 | Kirby Watson Peden | Family Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2006-12-28 |
| 1881755833 | Marcia Y Williams | Internal Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2006-12-13 |
| 1336258268 | Gregory Lee Fisher | Physician Assistant | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2006-08-30 |
| 1154345353 | Horace Lee Cline | Emergency Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3224 | 2006-07-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
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| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992748297 | Travis David Whitehead | Emergency Medicine | 6 Player Ct Nw, Rome, GA 30165-2566 | 2006-06-14 |
| 1154379170 | William Scott Alexander II | Emergency Medicine | 304 Turner Mccall Boulevard, Floyd Center for Wound Care and Hyperbarics, Rome, GA 30165 | 2006-05-04 |
| 1952385254 | Louis A Dinatti | Emergency Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2005-12-01 |
| 1205399474 | Cynthia Louise Landers | Emergency Medicine | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2019-04-12 |
| 1962944900 | Etowah Emergency Physicians, LLC | Emergency Medicine | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2016-11-08 |
| 1205179223 | Laurie Urquhart | Emergency Medicine | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2013-03-27 |
| 1669765756 | Timothy Adam Clark | Emergency Medicine | 304 Shorter Ave Nw, Suite 201, Rome, GA 30165-4290 | 2011-05-23 |
| 1669799532 | Steven Leander Bouldin | Emergency Medicine | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2010-04-30 |
| 1174768402 | David Wyatt Saunders | Emergency Medicine | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2008-12-16 |
| 1851508964 | Jonathan Garrett Gore | Emergency Medicine | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2007-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.