Caleb Blackburn, DDS, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

73026 Issued in TN

Practice address

1930 Alcoa Hwy Ste 335
Knoxville, TN 37920-1585

Phone

(865) 305-9000

NPI assigned

Apr 3, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial Surgery

Education

University of Tennessee, HSC, College of Medicine, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cblackburn3014222@carolinashealthcaresystem.direct-ci.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.

• DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Rock Hill, SC
  • NPI 1861913022

  Single Specialty

  NPD (past)
• DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Charlotte, NC
  • NPI 1972554186

  Oral and Maxillofacial Surgery

  NPD (past)

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

• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1346297892
  Care Compare affiliation

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

{
    "created_epoch": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1215433685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 ALCOA HWY STE 335",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201585",
            "telephone_number": "865-305-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 ALCOA HWY STE 335",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201585",
            "telephone_number": "865-305-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Rocky Slope Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296073908",
            "country_code": "US",
            "telephone_number": "864-751-9972",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8840 Blakeney Professional Dr",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282776718",
            "country_code": "US",
            "telephone_number": "704-716-9840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "CALEB",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-03",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NC",
            "license": "202500269",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TN",
            "license": "73026",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "11013",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Black
• William D Black, MD
• Van Tyler Blackaby, PMHNP-BC
• Blackbird Nutrition Therapy
• Bethany Wilma Wright Blackburn, MD
• Jacqueline Beth Blackburn, NP-C
• Melissa Blackburn
• Cody Blackford, ATC, LAT, CSCS
• Blackridge Dentistry LLC
• Kay Blackwelder, MS

• Oral & Maxillofacial Surgery (D.M.D.) in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; 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.