Jateum Mauree Blackburn, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

20240 Issued in TN

Practice address

2253 Chambliss Ave NW Ste 400
Cleveland, TN 37311-3861

Phone

(423) 476-5002

Fax

(423) 476-5969

NPI assigned

Aug 4, 2015

Last updated

Dec 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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, 2015

Medicare assignment

May accept Medicare assignment

Group practices

Bradley Physician Services, LLCGroup PAC ID 8123563392, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adoration Home Health and Hospice Care East TN Home health agency, Cleveland, TN, CCN 447279
• Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185
• Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jateum.blackburn.1@1525.direct.athenahealth.com
• Direct secure messaging: jateum.blackburn.1@31613.direct.athenahealth.com

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.

• Bradley Physician Services, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Cleveland, TN
  • NPI 1710727540

  Family

  Medicare reassignment Care Compare group NPD
• Advanced Practice Alliance

  • Family Medicine Physician
  • East Ridge, TN
  • NPI 1336950807
  NPD (past)
• Dennis Clifford Ford MD

  dba Ford Center for Pain Management

  • Non-Pharmacy Dispensing Site
  • Cleveland, TN
  • NPI 1245241892
  NPD (past)
• Mahmood a Siddiqui MD PC

  • Internal Medicine Physician
  • Copperhill, TN
  • NPI 1427070523
  NPD (past)

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

• Athens Regional Medical Center LLC

  dba Starr Regional Medical Center

  • General Acute Care Hospital
  • Athens, TN
  • NPI 1669567319
  Care Compare affiliation
• Bradley Medical Center, LLC

  • General Acute Care Hospital
  • Cleveland, TN
  • NPI 1255171096
  Care Compare affiliation
• Home Health Care of East Tennessee, Inc.

  dba Adoration Home Health and Hospice Care East Tennessee

  • Home Health Agency
  • Cleveland, TN
  • NPI 1285617605
  Care Compare affiliation

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1265818983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 400",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-476-5002",
            "fax_number": "423-476-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2253 CHAMBLISS AVE NW STE 400",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113861",
            "telephone_number": "423-476-5002",
            "fax_number": "423-476-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "JATEUM",
        "middle_name": "MAUREE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "20240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jateum.blackburn.1@1525.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "2253 Chambliss Ave NW Ste 400",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373113861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bio-Medical Applications of Tennessee, Inc. (Fresenius Medical Care Bradley)
• Jamie Bird, NP-C
• Birthcare & Womens Health
• Black Bear Pharmacy, Inc.
• Black Bear Pharmacy, Inc. (PHD Pharmacy LTC)
• Briteny Christine Blackwell, RBT
• Jason Blair, DDS
• Lynnette Elise Blair, R.N.
• Nancy Marie Blank, M.D.
• BLC - Wellington-Gardens, LLC (Brookdale Mount Vernon Drive)

• Family Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.