Maggie Blackburn, MAGGIE BLACKBURN MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME99422 Issued in FL

Practice address

3410 Remington Run
Tallahassee, FL 32312-1473

Phone

(850) 644-2373

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1265595524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 REMINGTON RUN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 REMINGTON RUN",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323121473",
            "telephone_number": "850-644-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MAGGIE",
        "name_prefix": "Dr.",
        "credential": "MAGGIE BLACKBURN MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "190386",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME99422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01498484",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna J Bixler, ARNP-C
• Herman Black
• Jamison Black
• Michael Edward Black
• Johnnie Blackburn
• Richard E Blackburn, M.D.
• Sarah Elizabeth Blackburn
• Tricia Blackburn
• Jadae A Blackmon
• Jimmie M Blackmon

• General Practice Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.