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DAVAUL BLACKMON
NPI 1700771847
Nurse Practitioner - Acute Care in Montgomery, AL

Active since June 10, 2025PECOS Enrolled
2105 E SOUTH BLVD, MONTGOMERY, AL 36116(334) 747-2100 Get Directions Write a Review

NPPES record last updated: January 17, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jan 17, 2026, Jun 14, 2025 (2 updates tracked since 2025).

About Davaul Blackmon NPPES

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

DAVAUL BLACKMON (NPI 1700771847) is an individual acute care provider in Montgomery, Alabama, licensed in Alabama (2025023280) and active in the NPI registry since June 2025. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1700771847
Entity TypeIndividualMale
Primary Taxonomy363LA2100X
Provider Legal NameDAVAUL BLACKMON
Location Address2105 E SOUTH BLVDMontgomery, AL 36116-2409
Mailing Address310 Telluride LnMidland City, AL 36350-7034 · (334) 791-8748 · Fax (334) 791-8748
Phone(334) 747-2100
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateJune 10, 2025
Last NPPES UpdateJanuary 17, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 17, 2026
✔ NPI 1700771847 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2100X
License✔ Licensed in AL · 2025023280
2105 E SOUTH BLVD, Montgomery, AL 36116
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Davaul Blackmon is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6709394802
PECOS Enrollment IDI20250731002853, I20260116002383, I20260507001488
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 36116 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
$81.90 typical visit price
range $52.65 – $161.63
Typical copayment $20.47 (range $13.16 – $40.40)
Most-billed visit code 99203
Established Patient
$93.72 typical visit price
range $16.56 – $131.65
Typical copayment $23.43 (range $4.14 – $32.91)
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 20

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

CRISTA WANDA MARQUARDT C.R.N.A.
Nurse Anesthetist, Certified Registered
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 288-2100
PREMIER ANESTHESIA OF MONTGOMERY
General Acute Care Hospital
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 322-9983
THOMAS H. BOOTH II C.R.N.A.
Nurse Anesthetist, Certified Registered
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 386-3579
MR. MIHIR M PRADHAN M.D.
Family Medicine
2105 E SOUTH BLVD, BAPTIST MEDICAL CENTER SOUTH
MONTGOMERY, AL 36116
Montgomery County (334) 286-2987
SUSAN HAMILTON MITCHELL CRNA
Nurse Anesthetist, Certified Registered
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 288-2100
BREANNA ROSE GREIVING CRNA
Nurse Anesthetist, Certified Registered
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 747-2100
HOLLIE NICOLE SANDERS CRNA
Nurse Anesthetist, Certified Registered
2105 E SOUTH BLVD, BAPTIST HOSPITAL DEPT OF ANES
MONTGOMERY, AL 36116
Montgomery County (770) 643-5619
DR. MOHAMMED ALOMARI MD
Hospitalist
2105 E SOUTH BLVD
MONTGOMERY, AL 36116
Montgomery County (334) 288-2100

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 Davaul Blackmon's NPI number?

The NPI number for Davaul Blackmon is 1700771847. It was assigned to this individual provider in the NPPES registry on June 10, 2025.

Where is Davaul Blackmon located?

Davaul Blackmon practices at 2105 E South Blvd, Montgomery, AL 36116. The listed phone number is (334) 747-2100.

What is Davaul Blackmon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Is Davaul Blackmon enrolled in Medicare?

Yes. Davaul Blackmon is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Davaul Blackmon was last updated on January 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.