Robert Charles Blackmon IV, M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

MD035847 Issued in DC

Practice address

3720 Martin Luther King Jr Ave SE
Washington, DC 20032-1548

Phone

(202) 561-4190

NPI assigned

Mar 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Chemung Medical Services PC

  dba Arnot Medical Services

  • Internal Medicine Physician
  • Elmira, NY
  • NPI 1356378889
  NPD (past)
• Fort Edward Rescue Squad Inc

  • Ambulance
  • Fort Edward, NY
  • NPI 1427031319
  NPD (past)
• Franklin Primary Health Center, Inc

  dba Frisco City Family Medical Center

  • Federally Qualified Health Center (FQHC)
  • Frisco City, AL
  • NPI 1982024402
  NPD (past)
• Upstate Community Medical, PC

  • Hospitalist Physician
  • Syracuse, NY
  • NPI 1689620163
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407987076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2948",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200132948",
            "telephone_number": "660-232-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200321548",
            "telephone_number": "202-561-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "DC",
            "license": "MD035847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Blackford
• Marc Roy Blackman, M.D.
• Alexis Blackmon
• Elizabeth Grace Blackmon
• Iman Zhane Blackmon
• Wayne Douglas Blackmon, MD
• Tranicka Marie Blackmond-Ashton
• George William Blacknell Jr.
• Eric Blackson
• Joseph Blackson

• Geriatric Medicine (Internal Medicine) Physician in Washington, DC
• Providers in Washington, DC by specialty
• Geriatric Medicine (Internal Medicine) Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.