Willett Blake Coffman

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

35606 Issued in TN

Practice address

64 Palmer Dr
Jackson, TN 38305-8029

Phone

(731) 614-0728

NPI assigned

Mar 2, 2023

Last updated

Jun 10, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 15

Addresses

Other names 1

• Blake Coffman Professional name

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lexington Clinic CorpGroup PAC ID 2466468558, 23 clinicians

Lexington Hospital CorporationGroup PAC ID 7719896414, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stuart Community Hospital Inc Hospital, Stuart, VA, CCN 491310
• Houston County Community Hospital Hospital, Erin, TN, CCN 441322

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lexington Clinic Corp

  • Family Medicine Physician
  • Lexington, TN
  • NPI 1780652107

  Emergency Medicine, VA

  Medicare reassignment Care Compare group NPD
• Lexington Hospital Corporation

  • Emergency Medicine Physician
  • Lexington, TN
  • NPI 1083809669
  Medicare reassignment Care Compare group NPD
• Lexington Family Physicians LLC

  • Family Medicine Physician
  • Lexington, TN
  • NPI 1265660708

  VA

  Medicare reassignment NPD
• Shamrock Community Hospital Inc

  dba Houston County Community Hospital

  • Critical Access Hospital
  • Erin, TN
  • NPI 1811566540
  Medicare reassignment NPD
• Perry County Community Hospital Inc

  • Critical Access Hospital
  • Linden, TN
  • NPI 1528890480
  Medicare reassignment
• Stuart Community Hospital Inc

  • Critical Access Hospital
  • Stuart, VA
  • NPI 1477368603
  Medicare reassignment
• Lexington Hospital Corporation

  dba Henderson County Community Pharmacy

  • Clinic Pharmacy
  • Lexington, TN
  • NPI 1033888649
  NPD
• Lexington Hospital Corporation

  dba Henderson County Medical Group

  • Emergency Medicine Physician
  • Lexington, TN
  • NPI 1407290893
  NPD
• Lexington Hospital Corporation

  dba Henderson County Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Lexington, TN
  • NPI 1073584751
  NPD (past)
• Lexington Hospital Corporation

  dba Henderson County Community Hospital

  • General Acute Care Hospital
  • Lexington, TN
  • NPI 1255302923
  NPD (past)
• Shamrock Community Hospital Inc.

  dba Houston County Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Erin, TN
  • NPI 1952011520
  NPD (past)

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

• Shamrock Community Hospital Inc

  dba Houston County Community Hospital

  • Critical Access Hospital
  • Erin, TN
  • NPI 1811566540
  Care Compare affiliation
• Stuart Community Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Stuart, VA
  • NPI 1194511568
  Care Compare affiliation
• Stuart Community Hospital Inc

  • Critical Access Hospital
  • Stuart, VA
  • NPI 1477368603
  Care Compare affiliation

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

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1578262192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 PALMER DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058029",
            "telephone_number": "731-614-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 PALMER DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383058029",
            "telephone_number": "731-614-0728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18688 Jeb Stuart Hwy",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "VA",
            "postal_code": "241711559",
            "country_code": "US",
            "telephone_number": "276-692-9020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2545 N Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Brownsville",
            "state": "TN",
            "postal_code": "380121687",
            "country_code": "US",
            "telephone_number": "731-307-3777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5001 E Main St",
            "address_purpose": "LOCATION",
            "city": "Erin",
            "state": "TN",
            "postal_code": "370614115",
            "country_code": "US",
            "telephone_number": "931-289-4158",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 W Church St",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "TN",
            "postal_code": "383512038",
            "country_code": "US",
            "telephone_number": "731-968-3646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "WILLETT",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "35606",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "35606",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0024195588",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "COFFMAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Hollie Michelle Cochran, C.O.T.A
• Karen K Codjoe, MD
• Megan Everett Cody, FNP-C
• Bobbie Coffman, P.A.
• Hannah Rachele Coffman, LPC/MHSP
• Sherri B Coker, SLP
• Tasha Cole-Bradshaw
• Donna D Cole, LCSW
• Kip Tracy Cole
• Lynn Cole, H.I.S

• Nurse Practitioner in Jackson, TN
• Providers in Jackson, TN by specialty
• Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; 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.