Lisa R Blackrick, MD

Primary specialty

Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X

License

ME144788 Issued in FL

Practice address

3627 University Blvd S Ste 550
Jacksonville, FL 32216-7401

Phone

(904) 379-5986

Fax

(904) 551-0282

NPI assigned

Jun 5, 2007

Last updated

Sep 14, 2020By 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

Medicare fee-for-service enrollment

Enrolled in PA, FL2 enrollments

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 2

Specialty

Orthopedic Surgery

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hughston Clinic Southeast PCGroup PAC ID 9234423971, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Memorial Hospital Hospital, Jacksonville, FL, CCN 100179
• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.blackrick.1@321.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.

• Hughston Clinic Southeast PC

  • Orthopaedic Surgery Physician
  • Columbus, GA
  • NPI 1225401946

  FL

  Medicare reassignment Care Compare group NPD
• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  Medicare reassignment NPD
• Hughston Clinic Southeast PC

  • Durable Medical Equipment & Medical Supplies
  • Nashville, TN
  • NPI 1770004863
  NPD
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
  • NPI 1720036601
  NPD

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

• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation Hospital Bartram Campus

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  dba Brooks Rehabilitation

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation
• Memorial Healthcare Group Inc

  dba HCA Florida Memorial Hospital

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1447206438
  Care Compare affiliation

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1386846871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "fax_number": "706-494-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S STE 550",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322167401",
            "telephone_number": "904-379-5986",
            "fax_number": "904-551-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4689 Highway 17",
            "address_2": "Suite 11",
            "address_purpose": "LOCATION",
            "city": "Fleming Island",
            "state": "FL",
            "postal_code": "32003",
            "country_code": "US",
            "telephone_number": "904-375-8850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKRICK",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "FL",
            "license": "ME144788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Blackmon, CRNA
• Ginger Blackmon, PHARMD
• Karen Elaine Blackmon, PHD
• Lee Blackmon
• Stephanie Rachell Blackmon
• Deborah Blackshear, PT
• Joseph Blackshear, MD
• Tara Renee Blackshear
• Blackstone Home Healthcare LLC
• Caleb Read Blackstone

• Orthopaedic Trauma Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Orthopaedic Trauma Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.