Active NPI
Dion Marcellus Blackmon, L.AC
- Acupuncturist
- Fairfax, VA
National Provider Identifier
1306663349
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 0121001177
- Practice address
- 10560 Main St Ste 403
Fairfax, VA 22030-7174 - Phone
- (703) 594-9157
- NPI assigned
- Sep 23, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 0121001177 | VA | Primary |
| Acupuncturist | 171100000X | U03052 | MD |
Addresses
Primary practice location
10560 Main St Ste 403
Fairfax, VA 22030-7174
Mailing address
10560 Main St Ste 403
Fairfax, VA 22030-7174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| U03052 | MD | MD | Acupuncturist |
| 0121001177 | VA | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Acupuncture LLC | Acupuncturist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734220800000",
"number": "1306663349",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10560 MAIN ST STE 403",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10560 MAIN ST STE 403",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220307174",
"telephone_number": "703-594-9157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMON",
"first_name": "DION",
"middle_name": "MARCELLUS",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-23",
"last_updated": "2024-12-15",
"certification_date": "2024-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "VA",
"license": "0121001177",
"primary": true
},
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MD",
"license": "U03052",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.