ALICE T BLACKMON PNP-C - NPI 1265413264 - Nurse Practitioner in San Antonio, TX

Q: What is Alice Blackmon's NPI number?

The NPI number for Alice Blackmon is 1265413264. It was assigned to this individual provider in the NPPES registry on November 8, 2005. The provider is also known as Alicia T Blackmon Pnp-C.

Q: What is Alice Blackmon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Q: When was this NPI record last updated?

The NPPES record for Alice Blackmon was last updated on March 9, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Alice T Blackmon Pnp-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICE T BLACKMON PNP-C (NPI 1265413264) is an individual pediatrics provider in San Antonio, Texas, licensed in Texas (AP108315) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265413264

Entity TypeIndividualFemale

Primary Taxonomy363LP0200X

Provider Legal NameALICE T BLACKMONCredential: PNP-C

Location Address7323 MARBACH RD STE 104San Antonio, TX 78227-1905

Mailing Address7323 Marbach Rd Ste 104San Antonio, TX 78227-1905 · (210) 674-0257 · Fax (210) 369-9064

Phone(210) 645-4305

Fax(210) 673-1850

Sole ProprietorNo

Enumeration DateNovember 8, 2005

Last NPPES UpdateMarch 9, 20269 updates tracked since enumeration

NPPES CertifiedMarch 9, 2026

✔ NPI 1265413264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0200X

License✔ Licensed in TX · AP108315

7323 MARBACH RD STE 104, San Antonio, TX 78227

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Other Names 1

Professional Name (2)Alicia T Blackmon Pnp-c

Other Identifiers 5

OtherAP108315TX · License

Other1508813494TX · Group Practice/billing Npi#

Other193200000XTX · Grp Taxonomy

Other363LP0200XTX · Individual Taxonomy

Other1265413264TX · Alice Blackmon, Pnp-c Npi#

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alice T Blackmon Pnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78227 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.92 typical visit price

range $54.84 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIEL H KELLUM SR. DO

Family Medicine