Warren D Blackburn Jr., M.D.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

10239 Issued in AL

Practice address

408 Clark St NE
Cullman, AL 35055-1953

Phone

(256) 734-3202

Fax

(256) 734-4668

NPI assigned

Nov 9, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1821079658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 CLARK ST NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350551921",
            "telephone_number": "256-739-1759",
            "fax_number": "256-739-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 CLARK ST NE",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350551953",
            "telephone_number": "256-734-3202",
            "fax_number": "256-734-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "WARREN",
        "middle_name": "D",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "AL",
            "license": "10239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL",
            "identifier": "51007164",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009982800",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "E873",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Maurice Black, PHARMD
• Deborah Dianne Black, MA
• Kristy Terry Black
• Natasha Black, MS
• Stephen Anthony Black, PD
• Gordon R Blair, CRNP
• Heidi Blair, M.D.
• Katie Blakely
• Traci Blalock
• Casey McCary Bloom, D.M.D.

• Rheumatology Physician in Cullman, AL
• Providers in Cullman, AL by specialty
• Rheumatology Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.