Roy M Blackburn, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD22132 Issued in OR

Practice address

2401 River Road
Suite 101
Eugene, OR 97404

Phone

(541) 344-8469

Fax

(541) 687-8631

NPI assigned

Mar 23, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345420800000",
    "number": "1316907629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849095",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752849095",
            "telephone_number": "541-344-8469",
            "fax_number": "541-687-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RIVER ROAD",
            "address_2": "SUITE 101",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "97404",
            "telephone_number": "541-344-8469",
            "fax_number": "541-687-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "ROY",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "OR",
            "license": "MD22132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leeandra Raylene Black, MA, QMHP
• Stefanie Black
• Tim Black
• Blackbird Psychotherapy, LLC
• Jelena Blackburn
• Michael Gene Blackmore, LMT
• Kyndra Blacks, LMT
• Carrie Blackwell, LMT
• Karen Renee Blackwell, LCSW
• Keith Blackwell, PT

• Physical Medicine & Rehabilitation Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Physical Medicine & Rehabilitation Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.