MR. JONATHAN BLACKMON IDC
NPI 1619916186
Military Health Care Provider - Independent Duty Corpsman in Saint Marys, GA

Q: What is Jonathan Blackmon's NPI number?

The NPI number for Jonathan Blackmon is 1619916186. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Q: What is Jonathan Blackmon's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Blackmon was last updated on August 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 06, 2006

603 WILD GRAPE DR, SAINT MARYS, GA 31558(912) 573-2940 Get Directions Write a Review

NPPES record last updated: August 12, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mr. Jonathan Blackmon Idc NPPES

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

MR. JONATHAN BLACKMON IDC (NPI 1619916186) is an individual independent duty corpsman provider in Saint Marys, Georgia and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1619916186

Entity TypeIndividualMale

Primary Taxonomy1710I1002X

Provider Legal NameMR. JONATHAN BLACKMONCredential: IDC

Location Address603 WILD GRAPE DRSaint Marys, GA 31558-3619

Mailing Address881 Uss James Madison Rd, Naval Submarine Support Center Medical DepartmentKings Bay, GA 31547-2531 · (912) 573-2940

Phone(912) 573-2940

Sole ProprietorYes

Enumeration DateJune 6, 2006

Last NPPES UpdateAugust 12, 2021

NPPES CertifiedAugust 12, 2021

✔ NPI 1619916186 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMilitary Health Care Provider · Independent Duty CorpsmanOther Service Providers

Taxonomy Code1710I1002X

Definition

A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals.

Also ListedSpecialist/Technologist, Pathology · Medical TechnologistTaxonomy 246QM0706X

603 WILD GRAPE DR, Saint Marys, GA 31558

Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Blackmon's NPI number?

The NPI number for Jonathan Blackmon is 1619916186. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Jonathan Blackmon located?

Jonathan Blackmon practices at 603 Wild Grape Dr, Saint Marys, GA 31558. The listed phone number is (912) 573-2940.

What is Jonathan Blackmon's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Corpsman, with taxonomy code 1710I1002X.

When was this NPI record last updated?

The NPPES record for Jonathan Blackmon was last updated on August 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.