DR. JEFFREY BLACKWELL (NPI# 1013544774) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013544774 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY BLACKWELL |
| Credential | MD, PHD |
| Practice Address |
208 Medical Park Blvd Bristol TN 37620-7343 |
| Practice Telephone | 4239894050 |
| Practice Fax Number | 4239903044 |
| Mailing Telephone | 4239894050 |
| Mailing Fax Number | 4239903044 |
| Enumeration Date | 2020-03-24 |
| Last Update Date | 2020-03-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831167451 | Jeffrey S Blackwell | Family Medicine | 3927 Rucker Ave, Everett, WA 98201-4833 | 2006-03-09 |
| Street Address |
208 MEDICAL PARK BLVD |
| City | BRISTOL |
| State | TN |
| Zip Code | 37620-7343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205835402 | Leonard Brian Cross | Pharmacist | 208 Medical Park Blvd, Bristol, TN 37620 | 2005-07-19 |
| 1124649116 | Jessie Paige Feathers | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-04-30 |
| 1740800150 | Luke M Hall | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-04-26 |
| 1487274916 | Kayla Arthur | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-04-24 |
| 1639798408 | Anne Abram Jarrell | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-04-13 |
| 1689201691 | Donald K Huffman | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-03-27 |
| 1376170514 | Nathan Bolton | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-03-26 |
| 1134756547 | Kendra Mackenzie Henderson | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2020-03-25 |
| 1457814873 | Danielle Lynn Jones Weston | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2019-04-11 |
| 1912468372 | Eric Deward Eddy | Student in an Organized Health Care Education/Training Program | 208 Medical Park Blvd, Bristol, TN 37620-7343 | 2019-03-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376180216 | Firstep, LLC | Psychiatry & Neurology | 3183 W. State St., Suite 1201, Bristol, TN 37620 | 2019-12-10 |
| 1578047726 | Amanda Harville Mcgrady | Psychologist | 105 Walnut Circle, Bristol, TN 37620 | 2018-09-23 |
| 1467932533 | Teresa Mooney | Nurse Practitioner | 324 Leslie Ct, Bristol, TN 37620 | 2018-08-17 |
| 1992285308 | Jeremy Aurbrey Blanzy | Nurse Practitioner | 1 Medical Park Boulevard, Suite 400e, Bristol, TN 37620 | 2018-08-15 |
| 1255841805 | Amanda L Pillion | Audiologist | 225 Midway Medical Park, Bristol, VA 37620 | 2017-10-10 |
| 1841717717 | Joel Blevins | Driver | 301 Webb Ct, Bristol, TN 37620 | 2017-08-23 |
| 1831579796 | Dr. Marie Crawford, Ph.d., Pllc | Psychologist | 739 Bluff City Highway, Suite 5, Bristol, TN 37620 | 2015-06-05 |
| 1508297169 | Cassandra Marie Conry | Chiropractor | 800 Hill St., Bristol, TN 37620 | 2013-12-09 |
| 1780025874 | Laura Leann Lawson-renfro | Nurse Practitioner | 260 Midway St, Bristol, TN 37620 | 2013-07-17 |
| 1760822365 | Ricky Bhimani | Internal Medicine | 208 Medical Park Boulevard, Bristol, TN 37620 | 2013-06-27 |
| Find all providers in zip 37620 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093344301 | Matthew Rodziewicz | Student in an Organized Health Care Education/Training Program | 118 Cherry Hill Dr, Bristol, CT 06010-2573 | 2020-04-07 |
| 1801354089 | Haley Ferreira | Student in an Organized Health Care Education/Training Program | 41 Basswood Dr, Bristol, RI 02809-4911 | 2019-03-07 |
| 1932676244 | Lydia Rose Moran | Student in an Organized Health Care Education/Training Program | 43 Dewolf Ave, Bristol, RI 02809-3500 | 2018-10-25 |
| 1245724038 | Yin Chi | Student in an Organized Health Care Education/Training Program | 500 Bath Rd, Bristol, PA 19007-3105 | 2018-06-15 |
| 1013439488 | Theresa Rose Manolitsis | Student in an Organized Health Care Education/Training Program | 170 Pondview Lane, Bristol, CT 06010 | 2017-07-07 |
| 1619419520 | Courtney Wolf | Student in an Organized Health Care Education/Training Program | 35 Payton Ter, Bristol, CT 06010-9433 | 2016-11-09 |
| 1225423627 | Ijeoma Okeke | Student in an Organized Health Care Education/Training Program | 501 Bath Rd Dept Family, Bristol, PA 19007-3101 | 2015-04-02 |
| 1710596747 | David Ernst | Student in an Organized Health Care Education/Training Program | 225 N Main St, Bristol, CT 06010-4926 | 2020-07-27 |
| 1366068371 | Samantha D'souza | Student in an Organized Health Care Education/Training Program | 501 Bath Rd, Bristol, PA 19007-3101 | 2020-06-25 |
| 1558987552 | Kulin M Patel | Student in an Organized Health Care Education/Training Program | 501 Bath Rd, Bristol, PA 19007-3190 | 2020-06-25 |
| Find all providers in BRISTOL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.