Benjamin B Blackmon Jr., MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

10460 Issued in SC

Practice address

109 Blarney Dr
Columbia, SC 29223-6244

Phone

(803) 865-8200

Fax

(803) 419-7910

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Medical University of South Carolina College of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beach Anesthesia, LLCGroup PAC ID 6103924014, 91 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bblackmon28767@directmcleodehealth.org

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.

• Beach Anesthesia, LLC

  • Anesthesiology Physician
  • Myrtle Beach, SC
  • NPI 1215061429
  Medicare reassignment Care Compare group NPD
• Kershaw Anesthesia, LLC

  • Anesthesiology Physician
  • Camden, SC
  • NPI 1073986048
  Medicare reassignment NPD
• Musc Community Physicians

  • Internal Medicine Physician
  • Bamberg, SC
  • NPI 1841878006
  Medicare reassignment NPD
• Concordia Anesthesiology, Inc

  • Anesthesiology Physician
  • Atlanta, GA
  • NPI 1619296464

  SC

  Medicare reassignment NPD
• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  SC

  Medicare reassignment NPD
• Musc Community Physicians

  • Rural Health Clinic/Center
  • Bowman, SC
  • NPI 1225735772
  NPD
• Pain Management, LLC

  • Interventional Pain Medicine Physician
  • Mt Pleasant, SC
  • NPI 1104914076
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1851480396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 GLENWOOD CT",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292043361",
            "telephone_number": "803-467-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 BLARNEY DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292236244",
            "telephone_number": "803-865-8200",
            "fax_number": "803-419-7910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "BENJAMIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "SC",
            "license": "10460",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "SC",
            "license": "10460",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "10460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104602",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4129447",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECT HEALTH",
            "identifier": "104602",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "77778",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "050028865",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCP",
            "identifier": "2000024",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazmine Black
• Jonathan Black, MD
• Kaneisha Black, PSY.D
• Thomas Black, M.D.
• Melanie Diane Blackburn, M.D.
• Courtney Blackmon, RD LD
• Charlotte M. Blackstone
• Ayana Mashae Blackwell
• Denise Blackwell
• Edgar Andrew Blackwell III, PHARMD

• Anesthesiology Physician in Columbia, SC
• Providers in Columbia, SC by specialty
• Anesthesiology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.