Gerald G Blackwell, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

27170 Issued in TN

Practice address

2050 Meadowview Parkway
Kingsport, TN 37660-7332

Phone

(423) 230-5000

Fax

(423) 230-5097

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Cardiovascular Disease (Cardiology)

Education

JC Edwards School of Medicine, Marshall University, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wellmont Cardiology ServicesGroup PAC ID 5799970281, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Wellmont Cardiology Services

  • Cardiovascular Disease Physician
  • Kingsport, TN
  • NPI 1376575035

  TN

  Medicare reassignment Care Compare group
• Wellmont Medical Associates Inc

  • Pulmonary Disease Physician
  • Kingsport, TN
  • NPI 1780986257

  TN

  Medicare reassignment NPD
• Wellmont Medical Associates Inc

  • Family Medicine Physician
  • Big Stone Gap, VA
  • NPI 1174808216

  VA

  Medicare reassignment NPD
• Wellmont Medical Associates, Inc.

  • Psychiatry Physician
  • Johnson City, TN
  • NPI 1275393522
  NPD
• Wellmont Medical Associates, Inc.

  • Urgent Care Clinic/Center
  • Bristol, VA
  • NPI 1295193183
  NPD
• Wellmont Medical Associates, Inc.

  • Internal Medicine Physician
  • Johnson City, TN
  • NPI 1154789030
  NPD (past)

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

• Wellmont Health System

  • General Acute Care Hospital
  • Kingsport, TN
  • NPI 1487690400

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1689600587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "SUITE 6A",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-408-7220",
            "fax_number": "423-408-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 MEADOWVIEW PARKWAY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607332",
            "telephone_number": "423-230-5000",
            "fax_number": "423-230-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "GERALD",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "27170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5836361",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060034463",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "621112685",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3094989",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chad T Bishop
• Chelsey Bishop
• BKD Kingsport, LLC
• Amanda Blackburn, PHARMD
• Reid B Blackwelder, M.D.
• Dottie S Blades, MSW LCSW
• Kevin K Blake, NP
• Casey Jean Blakley, RPH
• Racheal Amanda Blakley, M.S OTR/L
• Kerri Elyse Blancarte, LPC

• All providers in Kingsport, TN
• Cardiovascular Disease Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2014; 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.