Shannon Renee Blackmer, M. D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

0101250670 Issued in VA

Practice address

Nmrtc, Directorate of Public Health Services
620 John Paul Jones Circle
Portsmouth, VA 23708

Phone

(757) 953-0613

NPI assigned

Nov 20, 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

Medicare fee-for-service enrollment

Enrolled in VA

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

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1346314739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 TUCKER DR",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234353573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NMRTC, DIRECTORATE OF PUBLIC HEALTH SERVICES",
            "address_2": "620 JOHN PAUL JONES CIRCLE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "23708",
            "telephone_number": "757-953-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMER",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2021-10-06",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A97553",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "VA",
            "license": "0101250670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann A Bird, PHARMD
• Corbin Bird, PA-C
• Frederick Thomas Birsch, DDS
• Laurie Birsch, D.D.S.
• Craig Ernest Bischoff, MD
• T Blackwell, R.PH
• Philip Joseph Blaine, PHARM.D.
• Keisha Natasha Blair, M.D.
• Christopher Blais, PT, DPT
• Emily Blake

• Occupational Medicine Physician in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Occupational Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.