Edward B Blackmon Jr., MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M0326 Issued in TX

Practice address

1907 Highway 97 E Ste 220
Jourdanton, TX 78026-1538

Phone

(830) 769-5916

Fax

(830) 769-5917

NPI assigned

Nov 22, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Medical University of South Carolina College of Medicine, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Westover Hills Women's Health PAGroup PAC ID 9830116169, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Westover Hills Women's Health PA

  • Obstetrics & Gynecology Physician
  • San Antonio, TX
  • NPI 1477765824
  Medicare reassignment Care Compare group NPD
• Obhg Texas Holdings, P.a.

  • Obstetrics & Gynecology Physician
  • Austin, TX
  • NPI 1083917769
  Medicare reassignment NPD
• Timberland Medical Group

  • Family Medicine Physician
  • Cedar Park, TX
  • NPI 1528061157

  Obstetrics & Gynecology

  Medicare reassignment NPD
• Timberland Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Cedar Park, TX
  • NPI 1023790045
  NPD
• Christus Santa Rosa Health Care Corporation

  dba CHRISTUS Santa Rosa Hospital

  • General Acute Care Hospital
  • San Antonio, TX
  • NPI 1194787218
  NPD (past)
• Summa Physicians LLC

  dba Summa Health Medical Group

  • Geriatric Medicine (Internal Medicine) Physician
  • Uniontown, OH
  • NPI 1457662769
  NPD (past)

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1114092251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1907 HIGHWAY 97 E",
            "address_2": "SUITE 220",
            "city": "JOURDANTON",
            "state": "TX",
            "postal_code": "78026",
            "telephone_number": "830-769-5916",
            "fax_number": "830-769-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 HIGHWAY 97 E STE 220",
            "city": "JOURDANTON",
            "state": "TX",
            "postal_code": "780261538",
            "telephone_number": "830-769-5916",
            "fax_number": "830-769-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "EDWARD",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "M0326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "349733YLLW",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171496601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Atascosa County (Atascosa County EMS)
• Atascosa Emergency Medicine Associates PA
• Atascosa Physician Services, PA
• Bio-Medical Applications of Texas, Inc. (Fresenius Medical Care Tri City)
• Timothy Alan Bischoff, M.D.
• Ramona Brooks, DPM
• Gina L Campbell, ANP-C
• Terri Carpenter
• Martha Lee Casas, LCDC
• Anie A Cherian, D.P.M.

• Obstetrics & Gynecology Physician in Jourdanton, TX
• Providers in Jourdanton, TX by specialty
• Obstetrics & Gynecology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.