JAQUELINE DARE BLACKMON PMHNP
NPI 1689370769
Nurse Practitioner - Psychiatric/Mental Health in Ruskin, FL
About Jaqueline Dare Blackmon Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JAQUELINE DARE BLACKMON PMHNP (NPI 1689370769) is an individual psychiatric/mental health provider in Ruskin, Florida, licensed in Florida (11024186) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Jaqueline Dare Blackmon Pmhnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jaqueline Blackmon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Brandon, FL 33510
- Reassigned Medicare billing, Florida enrollment
- 3 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 33570 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Jaqueline Blackmon's NPI number?
The NPI number for Jaqueline Blackmon is 1689370769. It was assigned to this individual provider in the NPPES registry on February 1, 2023.
Where is Jaqueline Blackmon located?
Jaqueline Blackmon practices at 1610 Climbing Dayflower Dr, Ruskin, FL 33570. The listed phone number is (910) 584-0980.
What is Jaqueline Blackmon's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Jaqueline Blackmon enrolled in Medicare?
Yes. Jaqueline Blackmon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jaqueline Blackmon's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jaqueline Blackmon reassigns Medicare benefits to Whitechapel Behavioral Services (Brandon, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jaqueline Blackmon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jaqueline Blackmon accept?
Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, Cigna HealthCare of Florida, Inc. and Cigna Healthcare and 4 other insurers list Jaqueline Blackmon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Jaqueline Blackmon was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Jaqueline Dare Blackmon, PMHNP · NPI 1689370769
Psychiatric/Mental Health physician in Ruskin, Florida. Individual provider, active in the CMS NPPES registry since February 1, 2023.
## Identity
- **NPI:** 1689370769 (Entity type: Individual)
- **Enumerated:** February 1, 2023
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 11024186 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 1610 CLIMBING DAYFLOWER DR, Ruskin, FL 33570-4949
- **Phone:** (910) 584-0980
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Whitechapel Behavioral Services (NPI 1245941343, Brandon, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** February 1, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1689370769) · Data from the CMS NPPES public registry.