DAVID BLACKMON (PH.D.) – Clinical Psychologist, NPI 1144338211

DAVID BLACKMON (PH.D.) is a healthcare provider. based in Ponte vedra beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PY0004360 (FL). The NPI Number for DAVID BLACKMON (PH.D.) is 1144338211

Main info

Male
Sole Proprietor
37 Years Of Experience
Accepts Medicare Assignment
Name
DAVID BLACKMON (PH.D.)
NPI
1144338211
Phone
(904) 333-3389
Address
330 A1A N STE 325
Enumeration Date
28 August 2006
Last Update Date
10 October 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043333389
Graduation Year
1989 (37 years ago)
PAC ID
6002083003
Professional Enrollment ID
I20120113000658
Address ID
FL322502492JA1400XPKWY402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,602 CLINICAL PSYCHOLOGIST in FL

Provider Addresses for DAVID BLACKMON (PH.D.)

  • 330 A1A N STE 325

    PONTE VEDRA BEACH, FL 320821826

    Phone: (904) 333-3389

    Fax: (904) 713-2989

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-01-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120113000658IClinical PsychologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour4912$0
View full utilization report →

Insurance plans in this area (ZIP 32082)

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Reviews

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Frequently asked questions

What unique ID ties claims to DAVID BLACKMON (PH.D.)?
NPI 1144338211 is assigned to DAVID BLACKMON (PH.D.) under the national enumeration system.
Does this profile mean DAVID BLACKMON (PH.D.) is currently active?
Yes — DAVID BLACKMON (PH.D.) appears active in the national provider directory.
What does DAVID BLACKMON (PH.D.) treat or focus on?
Patients typically see DAVID BLACKMON (PH.D.) under the specialty Clinical Psychologist. Clinical services aligned with this taxonomy classification.
Where does public data place DAVID BLACKMON (PH.D.)?
The snapshot lists Ponte Vedra Beach, Florida for DAVID BLACKMON (PH.D.); download NPPES for the complete set.
What if Ponte Vedra Beach, Florida seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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