Vicki A Blackmon-Davis, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

F9213 Issued in TX

Practice address

1020 N Collins St
Arlington, TX 76011-6134

Phone

(972) 525-9900

Fax

(469) 333-7988

NPI assigned

Aug 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: vicki.blackmon-davis.1@13711.direct.athenahealth.com

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1861403313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 360541",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152516541",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N COLLINS ST",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760116134",
            "telephone_number": "972-525-9900",
            "fax_number": "469-333-7988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8680 main st.",
            "address_purpose": "LOCATION",
            "city": "frisco",
            "state": "TX",
            "postal_code": "75034",
            "country_code": "US",
            "telephone_number": "972-377-2447",
            "fax_number": "972-377-3006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMON-DAVIS",
        "first_name": "VICKI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "TX",
            "license": "F9213",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F9213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vicki.blackmon-davis.1@13711.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Village Medical Texas",
            "address_1": "1020 N Collins St",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760116134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Daniel Joseph Blackaby, D.O.
• Blacketer Enterprises, Inc
• Jodi Marie Blacketer, PT
• Lisa Blackman, M.S., R.D., L.D
• Treva Blackman, SLP
• Michael Alan Blair, M.D.
• Paris M Blake, LMFT
• Katrina Blakely, RN
• Tracy Scott Blakley Jr., DC
• Susan Blanchard, LPC

• Internal Medicine Physician in Arlington, TX
• Providers in Arlington, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.