Lee Ann Blackmon, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD.21391 Issued in AL

Practice address

1600 7TH Ave S
Suite 500
Birmingham, AL 35233-1711

Phone

(205) 939-9810

Fax

(205) 939-9949

NPI assigned

May 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• The Children'S Hospital of Alabama

  • Psychologist
  • Birmingham, AL
  • NPI 1114025103

  Psychiatry

  NPD (past)
• The Children'S Hospital of Alabama

  • Children's Hospital
  • Birmingham, AL
  • NPI 1205935012
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1891741567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11407 DRAWER 1492",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352461492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "address_2": "SUITE 500",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-939-9810",
            "fax_number": "205-939-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "LEE ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "AL",
            "license": "MD.21391",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.21391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115836",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC",
            "identifier": "511-03877",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051039780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-02194",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE SOUTH",
            "identifier": "1891741567",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "98345",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115827",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BC",
            "identifier": "511-03879",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "511-02189",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Elizabeth Blacklidge
• Alexis T Blackmon
• Ashley Renae Blackmon
• Ellen Barton Blackmon, M.D.
• Hunter Montgomery Blackmon
• Mary Olivia Blackmon
• Belinda J Blackstone, MS, CCC-A
• Michael Warner Blackstone Sr., MD
• Shane Renee Blackwell Miller
• Brent Blackwell

• Psychiatry Physician in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Psychiatry Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.