Raymond C Blackburn, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

F2557 Issued in TX

Practice address

8200 Brookriver Dr
Ste N705
Dallas, TX 75247-4069

Phone

(214) 630-5256

Fax

(214) 630-2251

NPI assigned

Apr 20, 2006

Sex

Male

Sole proprietor

Yes

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.

• Raymond C. Blackburn, M.D.

  • Dermatology Physician
  • Dallas, TX
  • NPI 1952789729
  NPD (past) Authorized official
• Blackburn Woolfolk Dermatology, PLLC

  • Dermatology Physician
  • Irving, TX
  • NPI 1447619291
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398902400000",
    "number": "1831154988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 BROOKRIVER DR",
            "address_2": "STE N705",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474069",
            "telephone_number": "214-630-5256",
            "fax_number": "214-630-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 BROOKRIVER DR",
            "address_2": "STE N705",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752474069",
            "telephone_number": "214-630-5256",
            "fax_number": "214-630-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "RAYMOND",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F2557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy Scott Black, LMSW
• William Christopher Black, MD
• Blackburn Management
• Blackburn Procurement LLC
• Kyle Blackburn, M.D.
• Steven Blackburn, D.D.S
• Blackett & Smith PLLC
• Tashya A Blacklock, PA
• Blair Blackman, RN, CPNP
• Katriena Lashaun Blackman, L.V.N.

• Dermatology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Dermatology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.