Katherine Anne Blackmon, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

002403 Issued in GA

Practice address

1305 Jennings Mill Rd Ste 230
Watkinsville, GA 30677

Phone

(706) 552-1700

NPI assigned

Jun 28, 2007

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

Doctor of Medicine

State licenses

Practice roles

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.

• Piedmont Athens Primary Care LLC

  • Family Medicine Physician
  • Athens, GA
  • NPI 1245746783
  NPD (past)

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535414400000",
    "number": "1801093471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD STE 230",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777241",
            "telephone_number": "706-552-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD STE 230",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "30677",
            "telephone_number": "706-552-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2018-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "002403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethel Haven Inc.
• Bethel Haven, Inc
• Miranda Lynn Bieber
• Kathryn Guy Birch, PH.D.
• Ryan Bishop, RBT
• Andrew James Blackowiak, MSW
• Holly Cheyenne Blalock
• Audrey Blanchard, LMT
• Joseph Blaney, NBC-HWC
• Ashley Keith Blanton, LPC

• All providers in Watkinsville, GA
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.