Mark Blair, M.D.
Individual provider Active NPI Surgery Physician · Tullahoma, TN
NPI 1508869561 · NPPES record last updated Feb 15, 2023
Key facts
- NPI
- 1508869561
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- MD34454 (TN)
- Practice address
- 100 William Northern Blvd
Tullahoma, TN 37388-4754 - Phone
- (931) 461-1150
- Fax
- (888) 498-3372
- NPI assigned
- May 24, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- General Surgery
- Education
- Indiana University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
100 William Northern Blvd
Suite a
Tullahoma, TN 37388-4754
Phone (931) 461-1150
Hospital & facility affiliations
- Southern Tennessee Regional Health System Winchest
- Unity Medical Center
- Vanderbilt Tullahoma-Harton Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 70 |
| Hernia repair - groin (open) | 1-10 |
| Hernia repair (minimally invasive) | 1-10 |
| Mastectomy | 1-10 |
| Upper gastrointestinal (GI) endoscopy for acid reflux | 74 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 1-10 |
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040329000336 | TN | Practitioner - General Surgery |
7618869132 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mark Blair MD PC | Surgery | Current |
Accepting new patients |
Locations
1750 Cedar Ln
Ste 100
Tullahoma, TN 37388
Phone (931) 455-7779
100 William Northern Blvd
Ste A
Tullahoma, TN 37388
Phone (931) 461-1150
100 William Northern Blvd
Tullahoma, TN 37388
Phone (931) 454-0489
725 Kings Ln
Tullahoma, TN 37388
Phone (931) 455-1976
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/HEIICD/Endpoint/HEIICD
- https://fhir4.healow.com/fhir/r4/HEIICD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD34454 | TN | Yes |
Addresses
Primary practice location
100 William Northern Blvd
Tullahoma, TN 37388-4754
Mailing address
PO Box 910
Tullahoma, TN 37388-0910
Phone (931) 461-1150
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 020053847 | Other | TN | IND RRMCR # |
| 7201687 | Other | TN | CIGNA HEALTHCARE |
| 3856436 | Medicaid | TN | |
| 4043202 | Other | TN | BCBS OF TN |
Other providers in Tullahoma, TN
- Stephen Hunter Bills
- Amanda Bingham
- Tamera Sue Bird
- Joel Stanley Birdwell
- BKD Tullahoma, LLC
- James Harrell Blanks
- Jacqueline D. Blanton
- Taylor Lanaux Blow
- Bluebird Recovery LLC
- Laurie Lynn Boland
All providers in Tullahoma, TN · Surgery Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 15, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.