Jeffrey M Blackmon, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD196707 Issued in OR

Practice address

929 SW Simpson Ave Ste 300
Bend, OR 97702-3599

Phone

(541) 389-7741

Fax

(541) 278-8375

NPI assigned

Jul 27, 2006

Last updated

Mar 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, TN, OR3 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 3

Specialty

Family Practice

Education

Medical College of Georgia School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Praxis Health PCGroup PAC ID 8325941446, 174 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeffreyblackmon@tnmhpf.allscriptsdirect.net

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.

• Praxis Health, PC

  • Multi-Specialty Clinic/Center
  • Bend, OR
  • NPI 1821068164

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545

  Family Medicine, GA

  Medicare reassignment NPD
• Praxis Health, PC

  dba Dallas Family Care

  • Rural Health Clinic/Center
  • Dallas, OR
  • NPI 1942925326
  NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Trenton

  • Rural Health Clinic/Center
  • Trenton, GA
  • NPI 1467602482

  Family Medicine

  NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Lafayette

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780

  Family Medicine

  NPD
• Floyd Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Rome, GA
  • NPI 1811907124
  NPD (past)
• Floyd Healthcare Management Inc

  dba Atrium Health Floyd Specialty Pharmacy

  • Specialty Pharmacy
  • Rome, GA
  • NPI 1548056468
  NPD (past)
• Interventional Pain Specialists of Georgia LLC

  • Interventional Pain Medicine Physician
  • Cartersville, GA
  • NPI 1205698396
  NPD (past)

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

• Cascade Healthcare Community Inc

  dba NW High Desert Sleep Center Bend

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1710901996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1517",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978010410",
            "telephone_number": "877-708-1119",
            "fax_number": "541-278-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "929 SW SIMPSON AVE STE 300",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023599",
            "telephone_number": "541-389-7741",
            "fax_number": "541-278-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "JEFFREY",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "55917",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD196707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "724476151G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle T Black, MD
• Taylor Jane Black
• Christopher Allen Blackburn, RN
• Whitney Blackham, LPC
• Jon Arthur Blackman, MD
• Elizabeth Blackwood, MSW, LCSW
• Ryan Elizabeth Blackwood
• Jessica J Bladt, CRM
• Gregory Paul Blair, M.D.
• Blake Drew DMD, PC (Drew Family Dentistry)

• Family Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.