DR. JEFFREY BLACKWELL (MD, PHD) – Family Medicine Physician, NPI 1013544774

DR. JEFFREY BLACKWELL (MD, PHD) is a healthcare provider. based in Johnson city, Tennessee. specializing in FAMILY PRACTICE. They hold the professional credentials MD, PHD. They hold a License No. 0101278580 (VA). The NPI Number for DR. JEFFREY BLACKWELL (MD, PHD) is 1013544774

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. JEFFREY BLACKWELL (MD, PHD)
NPI
1013544774
Phone
(423) 952-2111
Address
1021 W OAKLAND AVE STE 310
Enumeration Date
24 March 2020
Last Update Date
11 February 2026

Doctor Profile

Medical School Name
EAST TENNESSEE STATE UNIVERSITY QUILLEN COLLEGE OF MEDICINE
Secondary Phone
2764295163
Graduation Year
2020 (6 years ago)
PAC ID
2961826177
Group Practice PAC ID
0446168496
Professional Enrollment ID
I20230802002747
Address ID
VA243402712GL636XXDRXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

3,174 FAMILY PRACTICE in VA

Provider Addresses for DR. JEFFREY BLACKWELL (MD, PHD)

  • 1021 W OAKLAND AVE STE 310

    JOHNSON CITY, TN 376042192

    Phone: (423) 952-2111

    Type: Mailing

  • 12180 ALDER ST

    MEADOWVIEW, VA 24361

    Phone: (276) 695-0205

    Type: Location

  • 16000 Johnston Memorial Dr Ste 213

    Abingdon, VA 242110001

    Phone: (276) 258-2600

    Type: Location

  • 636 S Monte Vista Dr

    Glade Spring, VA 243402712

    Phone: (276) 429-5163

    Type: Location

  • 1785 W Lee Hwy

    Wytheville, VA 243821437

    Phone: (276) 228-6499

    Type: Location

  • 208 MEDICAL PARK BLVD

    BRISTOL, TN 376207343

    Phone: (423) 989-4050

    Fax: (423) 990-3044

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $335.

Total Amount is formed as General ($335) + Research ($0) + Ownership ($0) = $335.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Novo Nordisk Inc ($181).

Total Amount

$335

General + Research + Ownership

Payments

15

Total payment records

General Amount

$335

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-08-02

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
I20230802002747IFamily PracticeVATBD

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
99214Established patient office or other outpatient visit, 30-39 minutes2020$0
View full utilization report →

Insurance plans in this area (ZIP 37604)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446168496View full group profile

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What federal number belongs to DR. JEFFREY BLACKWELL (MD, PHD)?
The federal identifier for DR. JEFFREY BLACKWELL (MD, PHD) is NPI 1013544774.
Does this profile mean DR. JEFFREY BLACKWELL (MD, PHD) is currently active?
Yes — DR. JEFFREY BLACKWELL (MD, PHD) appears active in the national provider directory.
What does DR. JEFFREY BLACKWELL (MD, PHD) treat or focus on?
Patients typically see DR. JEFFREY BLACKWELL (MD, PHD) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location shows for DR. JEFFREY BLACKWELL (MD, PHD)?
We surface Johnson City, Tennessee for DR. JEFFREY BLACKWELL (MD, PHD) based on available NPPES addresses.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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