Tiffany Faye Blackmon, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

647872 Issued in TX

Practice address

11251 Terra Loop Rd
San Antonio, TX 78233-6832

Phone

(832) 326-5172

NPI assigned

Aug 19, 2018

Sex

Female

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1534636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534636800000",
    "number": "1689154684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 SAWGRASS RDG",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782607241",
            "telephone_number": "832-326-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11251 TERRA LOOP RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782336832",
            "telephone_number": "832-326-5172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "TIFFANY",
        "middle_name": "FAYE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-19",
        "last_updated": "2018-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "647872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blackland Prairie Medical PLLC
• Chris Blacklock, ATP
• Alice T Blackmon, PNP-C
• Ashley Blackmon, DPM
• Beatrice L Blackmon, LCSW
• Heather Blackmond, D.M.D.
• Ashley Blackmore
• Cory A Blacksmith, PHARMD
• Heather Payton Blacksmith, PHARM.D.
• Briana Donise Blackstock, MSN, NNP-BC

• All providers in San Antonio, TX
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.