Van Tyler Blackaby, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

36184 Issued in TN

Practice address

2018 Western Ave
Knoxville, TN 37921-5718

Phone

(865) 544-0406

Fax

(865) 544-0480

NPI assigned

May 20, 2013

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherokee Health SystemsGroup PAC ID 3577474295, 128 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: van.blackaby.p1@direct.cherokeehealth.nextgenshare.com

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

• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Talbott, TN
  • NPI 1134128820
  Medicare reassignment Care Compare group NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • White Pine, TN
  • NPI 1699666404
  NPD
• Cherokee Health Systems

  • Federally Qualified Health Center (FQHC)
  • Knoxville, TN
  • NPI 1174760920
  NPD (past)

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1205272010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 SULPHUR SPRINGS RD",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378135654",
            "telephone_number": "423-317-9344",
            "fax_number": "423-714-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2018 WESTERN AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379215718",
            "telephone_number": "865-544-0406",
            "fax_number": "865-544-0480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 W Springdale Ave",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379175158",
            "country_code": "US",
            "telephone_number": "865-637-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKABY",
        "first_name": "VAN",
        "middle_name": "TYLER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-20",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "36184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Black, OTR/L
• Sarah Black, PA-C
• Timothy R. Black, PA-C
• Tyler Black
• William D Black, MD
• Blackbird Nutrition Therapy
• Bethany Wilma Wright Blackburn, MD
• Caleb Blackburn, DDS, MD
• Jacqueline Beth Blackburn, NP-C
• Melissa Blackburn

• Psychiatric/Mental Health Nurse Practitioner in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.