BLAKE COFFMAN – Nurse Practitioner, NPI 1578262192

BLAKE COFFMAN is a healthcare provider. based in Stuart, Virginia. specializing in NURSE PRACTITIONER. They hold a License No. 0024195588 (VA). The NPI Number for BLAKE COFFMAN is 1578262192

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
BLAKE COFFMAN
NPI
1578262192
Phone
(276) 692-9020
Address
18688 Jeb Stuart Hwy
Enumeration Date
2 March 2023
Last Update Date
24 April 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7319681812
Graduation Year
2023 (3 years ago)
PAC ID
0749795011
Group Practice PAC ID
7719896414
Professional Enrollment ID
I20250715003423
Address ID
TN383512038LE200XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:3State licenses:2Digital endpointsOther names

8,303 NURSE PRACTITIONER in VA

Provider Addresses for BLAKE COFFMAN

  • 18688 Jeb Stuart Hwy

    Stuart, VA 241711559

    Phone: (276) 692-9020

    Type: Location

  • 200 W Church St

    Lexington, TN 383512038

    Phone: (731) 968-3646

    Type: Location

  • 5001 E Main St

    Erin, TN 370614115

    Phone: (931) 289-4158

    Type: Location

  • 2545 N Washington Ave

    Brownsville, TN 380121687

    Phone: (731) 307-3777

    Type: Location

  • 64 PALMER DR

    JACKSON, TN 383058029

    Phone: (731) 614-0728

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2025-07-15

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
I20250715003423INurse PractitionerTNTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 24171)

Loading plans...

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: 7719896414View full group profile
NameSpecialtyState
Family Practice, Emergency MedicineIL
Nurse PractitionerTN
Emergency Medicine, Internal MedicineTN
Nurse PractitionerTN
Nurse PractitionerTN
-TN
General SurgeryOH
Internal MedicineTX
Family PracticeVA
Internal MedicineTN

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

How do I look up BLAKE COFFMAN by NPI?
Use NPI 1578262192 when you need to reference BLAKE COFFMAN in forms, claims, or directories.
Is BLAKE COFFMAN's NPI currently valid?
The extract we use shows BLAKE COFFMAN as active.
Does BLAKE COFFMAN list a primary specialty?
If you are matching referrals, note Nurse Practitioner for BLAKE COFFMAN. Clinical services aligned with this taxonomy classification.
Where is BLAKE COFFMAN's primary listing?
We display Stuart, Virginia because that is what the record indicates for BLAKE COFFMAN.
How can I contact BLAKE COFFMAN?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

Similar Providers

ELIZABETH ANN SHOCKLEY (NP)

Family Nurse Practitioner
18877 JEB STUART HWY
NPI: 1861499691
PO BOX 171
NPI: 1003433590