ALICE T BLACKMON (PNP-C) – Pediatric Nurse Practitioner, NPI 1265413264
Pediatric Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ALICE T BLACKMON (PNP-C)
Kellum Medical Group, 7351, Marbach Road, San Antonio, Bexar County, Texas, 78227, United States
SUITE 107
SAN ANTONIO, TX 782271905
Phone: (210) 645-4305
Fax: (210) 673-1850
Type: Location
Marbach Road, San Antonio, Bexar County, Texas, 78245, United States
SAN ANTONIO, TX 782271905
Phone: (210) 674-0257
Fax: (210) 369-9064
Type: Mailing
7323 MARBACH RD STE 104
SAN ANTONIO, TX 782271905
Phone: (210) 645-4305
Fax: (210) 673-1850
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 89 Open Payments records for all available years, with a total value of $1,680.
Total Amount is formed as General ($1,680) + Research ($0) + Ownership ($0) = $1,680.
Last reported payment date: 2024-12-06 • Largest payer in this snapshot: Supernus Pharmaceuticals, Inc. ($311).
Total Amount
$1,680
General + Research + Ownership
Payments
89
Total payment records
General Amount
$1,680
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-06
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Supernus Pharmaceuticals, Inc. | $311 |
| Corium, LLC | $272 |
| Merck Sharp & Dohme LLC | $180 |
| ITI, Inc. | $141 |
| ITI, Inc. (d/b/a Intra-Cellular Therapies, Inc.) | $131 |
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: 2005-10-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051018000261 | I | Nurse Practitioner | TX | TBD |
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.
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 78227)
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