NPIMap

Individual provider Active NPI

Jeffrey Blackwell, MD, PHD

  • Family Medicine Physician
  • Meadowview, VA
National Provider Identifier
1013544774
Registry record updated Feb 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101278580 Issued in VA
Practice address
12180 Alder St
Meadowview, VA 24361
Phone
(276) 695-0205
NPI assigned
Mar 24, 2020
Last updated
Feb 11, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101278580 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

12180 Alder St
Meadowview, VA 24361

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 952-2111

Other practice location 1

636 S Monte Vista Dr
Glade Spring, VA 24340-2712
Phone (276) 429-5163

Other practice location 2

1785 W Lee Hwy
Wytheville, VA 24382-1437
Phone (276) 228-6499

Other practice location 3

16000 Johnston Memorial Dr Ste 213
Abingdon, VA 24211-0001
Phone (276) 258-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802002747 VA Practitioner - Family Practice 2961826177 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
East Tennessee State University Quillen College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

636 S Monte Vista Dr
Glade Spring, VA 24340-2712
Phone (276) 429-5163

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0101278580VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Smyth County Community Hospital CurrentSince Aug 1, 2023 Accepting new patients
Wellmont Medical Associates Inc Family Medicine CurrentSince Dec 20, 2023 Accepting new patients
Smyth County Community Hospital CurrentSince Aug 1, 2023 Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Dec 20, 2023 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Dec 21, 2023 Accepting new patients
Wellmont Health System Current Accepting new patients
Blue Ridge Medical Management Corporation Family Medicine CurrentSince Dec 21, 2023 Accepting new patients

Locations

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

16000 Johnston Memorial Dr
Ste 213
Abingdon, VA 24211
Phone (276) 258-2600

24530 Falcon Place Blvd
Ste 201
Abingdon, VA 24211
Phone (276) 619-3801

323 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-2612

391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406

1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111

743 Island Rd
Bristol, VA 24201
Phone (276) 469-4200

636 S Monte Vista Dr
Glade Spring, VA 24340
Phone (276) 429-5163

1205 Snider St
#B
Marion, VA 24354
Phone (276) 258-1777

1785 W Lee Hwy
Wytheville, VA 24382
Phone (276) 228-3355

Networks

  • KY PPO
  • KY PPO C-SNP
  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: jblackwell192507@balladhealth.medalliesdirect.net

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1013544774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-952-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12180 ALDER ST",
            "city": "MEADOWVIEW",
            "state": "VA",
            "postal_code": "24361",
            "telephone_number": "276-695-0205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "636 S Monte Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Glade Spring",
            "state": "VA",
            "postal_code": "243402712",
            "country_code": "US",
            "telephone_number": "276-429-5163",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1785 W Lee Hwy",
            "address_purpose": "LOCATION",
            "city": "Wytheville",
            "state": "VA",
            "postal_code": "243821437",
            "country_code": "US",
            "telephone_number": "276-228-6499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16000 Johnston Memorial Dr Ste 213",
            "address_purpose": "LOCATION",
            "city": "Abingdon",
            "state": "VA",
            "postal_code": "242110001",
            "country_code": "US",
            "telephone_number": "276-258-2600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-24",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101278580",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meadowview, VA

Sources for this page

Verify at the official NPI Registry.