Individual provider Active NPI

Jesse Aycock Blackman, M.D.

  • Family Medicine Physician
  • Pikeville, NC
National Provider Identifier
1811936826
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
18609 Issued in NC
Practice address
5413 US Highway 117 N
Pikeville, NC 27863-9445
Phone
(919) 242-5271
Fax
(919) 242-5096
NPI assigned
Jun 5, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 18609 NC Primary

Addresses

Primary practice location

5413 US Highway 117 N
Pikeville, NC 27863-9445

Mailing address

5413 US Highway 117 N
Pikeville, NC 27863-9445
Phone (919) 242-5271

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18609NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Medical Associates, PA PastSince Sep 1, 1998 Accepting new patients
Eastern Medical Associates, PA Family Medicine Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1811936826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5413 US HIGHWAY 117 N",
            "city": "PIKEVILLE",
            "state": "NC",
            "postal_code": "278639445",
            "telephone_number": "919-242-5271",
            "fax_number": "919-242-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5413 US HIGHWAY 117 N",
            "city": "PIKEVILLE",
            "state": "NC",
            "postal_code": "278639445",
            "telephone_number": "919-242-5271",
            "fax_number": "919-242-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "JESSE",
        "middle_name": "AYCOCK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "18609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikeville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.