Individual provider Active NPI

Courtney Jackson Blair, M.D.

  • Allergy & Immunology Physician
  • MC Lean, VA
National Provider Identifier
1730121344
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
0101243347 Issued in VA
Practice address
6888 Elm St Ste 301
MC Lean, VA 22101-3829
Phone
(703) 356-8290
Fax
(703) 356-8031
NPI assigned
Jun 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36113297 IL
Pediatrics Physician 208000000X 36113297 IL
Allergy & Immunology Physician 207K00000X 0101243347 VA Primary

Addresses

Primary practice location

6888 Elm St Ste 301
MC Lean, VA 22101-3829

Mailing address

1360 Beverly Rd
Ste 103
MC Lean, VA 22101-3621
Phone (703) 356-8290

Other names 1

  • Dr. Courtney Ann Jackson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, 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

Enrollment IDStateProvider typePAC IDDetails
I20081106000656 DC Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 4880753763 Reassigns benefits to 2 organizations
I20160317001568 VA Practitioner - Allergy/Immunology 4880753763 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Oregon Health Sciences University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

1360 Beverly Rd
Suite 103
McLean, VA 22101-3621
Phone (703) 356-8290

46400 Benedict Dr
Suite 3
Sterling, VA 20164-6604
Phone (703) 430-0833

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36113297ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Apr 1, 2016 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Inova Health Care Services Internal Medicine Current Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Privia Medical Group, LLC Allergy & Immunology CurrentSince Apr 1, 2016 Accepting new patients
Inova Health Care Services CurrentSince Mar 1, 2020 Accepting new patients
Allergy and Asthma Associates P.C. Past Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

224B Cornwall St NW
Leesburg, VA 20176
Phone (703) 771-2894

8644 Sudley Rd
#220
Manassas, VA 20110

1360 Beverly Rd
Ste 103
McLean, VA 22101
Phone (703) 356-8290

46400 Benedict Dr
Ste 3
Sterling, VA 20164
Phone (703) 430-0333

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: courtney.blair.1@8042.direct.athenahealth.com

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1730121344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BEVERLY RD",
            "address_2": "STE 103",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013621",
            "telephone_number": "703-356-8290",
            "fax_number": "703-356-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6888 ELM ST STE 301",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013829",
            "telephone_number": "703-356-8290",
            "fax_number": "703-356-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "COURTNEY",
        "middle_name": "JACKSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36113297",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "36113297",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "VA",
            "license": "0101243347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "JACKSON",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in MC Lean, VA

Sources for this page

Verify at the official NPI Registry.