Lee Blackmon

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

202100603 Issued in NC

Practice address

580 W 8TH St
6TH Floor, Suite 6005
Jacksonville, FL 32209-6533

Phone

(904) 244-3990

Fax

(904) 244-3455

NPI assigned

Mar 28, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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

Specialty

Psychiatry

Education

Medical University of South Carolina College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bon Secours Medical Group Greenville Specialty Care LLCGroup PAC ID 1850779976, 290 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lblackmon1284482@direct.bsmhealth.org

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.

• Bon Secours Medical Group Greenville Specialty Care LLC

  • Cardiovascular Disease Physician
  • Greenville, SC
  • NPI 1821679580

  Psychiatry

  Medicare reassignment Care Compare group NPD
• Bon Secours Medical Group Greenville Specialty Care LLC

  • Orthopaedic Surgery Physician
  • Fountain Inn, SC
  • NPI 1760361174
  NPD
• University of Florida Jacksonville Physicians Inc

  • Psychiatry Physician
  • Jacksonville, FL
  • NPI 1558521823
  NPD (past)

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1417489774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5003 S MIAMI BLVD",
            "address_2": "STE 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277038589",
            "telephone_number": "919-354-0840",
            "fax_number": "877-840-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 8TH ST",
            "address_2": "6TH FLOOR, SUITE 6005",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096533",
            "telephone_number": "904-244-3990",
            "fax_number": "904-244-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "86392",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "202100603",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "TRN24684",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monesha Blackman
• Kara Jean Blackmer, R.D., PA-C
• Ashley Blackmon, CRNA
• Ginger Blackmon, PHARMD
• Karen Elaine Blackmon, PHD
• Stephanie Rachell Blackmon
• Lisa R Blackrick, MD
• Deborah Blackshear, PT
• Joseph Blackshear, MD
• Tara Renee Blackshear

• Psychiatry Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 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.
• 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.