Jonathan C Blackmore, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

200500942 Issued in NC

Practice address

412 South East Center St
Faison, NC 28341

Phone

(910) 267-1942

NPI assigned

Jan 11, 2007

Last updated

Oct 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: jblackmore@goshenmedical.cloudcraftdirect.com

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540771200000",
    "number": "1972653269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "283410187",
            "telephone_number": "910-267-2042",
            "fax_number": "855-996-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 SOUTH EAST CENTER ST",
            "city": "FAISON",
            "state": "NC",
            "postal_code": "28341",
            "telephone_number": "910-267-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMORE",
        "first_name": "JONATHAN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2018-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "200500942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1489881",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jamille Aycock
• Mary C Bass, LCSW
• Taylor Brooke Blackburn
• Tonya Daughtry Blackman, PT
• Julie Marie Crawford, LPTA
• Teha Shonta Croswell, BIRTH DOULA
• Mian Bashir Daud, M.D.
• Lauren Eades, PA
• Bryan Francis, DDS

• Family Medicine Physician in Faison, NC
• Providers in Faison, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; 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.