Jon D Blachley, MD

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

E6238 Issued in TX

Practice address

6415 Deloache Ave
Dallas, TX 75225-2606

Phone

(469) 585-5209

NPI assigned

Aug 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340928000000",
    "number": "1619984440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6415 DELOACHE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752252606",
            "telephone_number": "469-585-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6415 DELOACHE AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752252606",
            "telephone_number": "469-585-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACHLEY",
        "first_name": "JON",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2012-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": "E6238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01022707",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ibienebo Nelly Biyi, PT
• James Eustace Bizzell II, M.D.
• Carol A Bjorkman, NP
• BK Neuromonitoring, PLLC
• Stephanie Ford Blache, MS, RN, CPNP
• Agnes Blachut, RDN, LD
• Alisha Black
• Alyssa Black
• Brandon Black, OPA-C
• Brandon Dustin Black, D.C.

• Critical Care Medicine (Internal Medicine) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Critical Care Medicine (Internal Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.