NPIMap

Individual provider Active NPI

Ronald L Blackmore, M.D.

  • Family Medicine Physician
  • Johnson City, TN
National Provider Identifier
1770547606
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD31358 Issued in TN
Practice address
101 Med Tech Pkwy Ste 100
Johnson City, TN 37604-4006
Phone
(423) 794-1800
Fax
(423) 794-1801
NPI assigned
Apr 17, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD31358 TN Primary

Addresses

Primary practice location

101 Med Tech Pkwy Ste 100
Johnson City, TN 37604-4006

Mailing address

101 Med Tech Parkway
Ste 100
Johnson City, TN 37604
Phone (423) 794-1800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070308000565 TN Practitioner - Family Practice 9234232463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Columbia School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

101 Med Tech Pkwy
Suite 100
Johnson City, TN 37604-4006
Phone (423) 794-1800

313 Princeton Rd
Suite 3
Johnson City, TN 37601-2000
Phone (423) 282-5435

444 Clinchfield St
Kingsport, TN 37660-3858

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions13
Removal of nail tissue1-10
Removal or shaving of skin growth26
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD31358TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
State of Franklin Healthcare Associates PLLC Family Medicine CurrentSince Jan 1, 2007 Accepting new patients
State of Franklin Healthcare Associates PLLC PastSince Aug 18, 2019 Accepting new patients

Locations

101 Med Tech Pkwy
Ste 100
Johnson City, TN 37604
Phone (423) 431-7626

1021 W Oakland Ave
Ste 301
Johnson City, TN 37604
Phone (423) 915-5234

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

5 Worth Cir
Ste 4
Johnson City, TN 37601
Phone (423) 282-4819

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ronaldblackmore@sofha.allscriptsdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770547606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MED TECH PARKWAY",
            "address_2": "STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "37604",
            "telephone_number": "423-794-1800",
            "fax_number": "423-794-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MED TECH PKWY STE 100",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044006",
            "telephone_number": "423-794-1800",
            "fax_number": "423-794-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "RONALD",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD31358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.