Michele Nicole Blackledge, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9327 Issued in TN

Practice address

3304 Courtney CT
Nashville, TN 37218-2708

Phone

(615) 244-8165

NPI assigned

Jun 22, 2011

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

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: mblackledge@direct.neighborhoodhealthtn.nextgenshare.com

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480377600000",
    "number": "1821384454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 MAIN ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372063605",
            "telephone_number": "615-620-8647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3304 COURTNEY CT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372182708",
            "telephone_number": "615-244-8165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKLEDGE",
        "first_name": "MICHELE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2016-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "9327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Black
• Mary-Kathryn Black, PH.D.
• Melissa A Black, RN
• Taylor Black, DPT
• Theodore Black, MD
• Gwendolyn Lefran Blackman, MS, RD, LDN
• Talisa Blackman
• Mark Blackmon, PA-C
• Zachary Bryant Blackmon, PHARMD
• Sandra Blackmore

• General Practice Dentistry in Nashville, TN
• Providers in Nashville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.