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MR. RAYMOND BLACKWELL LADAC II
NPI 1710599543
Counselor - Addiction (Substance Use Disorder) in Brush Creek, TN

Active since August 21, 2020PECOS Enrolled
832 MAIN ST SOUTH, BRUSH CREEK, TN 38547(615) 630-8908 Get Directions Write a Review

NPPES record last updated: August 10, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 10, 2026, Sep 28, 2020, Aug 21, 2020 (3 updates tracked since 2020).

About Mr. Raymond Blackwell Ladac Ii NPPES

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

MR. RAYMOND BLACKWELL LADAC II (NPI 1710599543) is an individual addiction (substance use disorder) provider in Brush Creek, Tennessee, licensed in Tennessee (LDC0000001425) and active in the NPI registry since August 2020. He is enrolled in Medicare PECOS, maintains a secondary practice location in Brentwood, and is a graduate of Other (2026).

NPPES Registry Identity

NPI1710599543
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. RAYMOND BLACKWELLCredential: LADAC II
Location Address832 MAIN ST SOUTHBrush Creek, TN 38547
Mailing Address811 Royal Elm CirHartsville, TN 37074-2004 · (615) 330-0161
Phone(615) 630-8908
Sole ProprietorYes
Medical School CMSOtherGraduated 2026
Enumeration DateAugust 21, 2020
Last NPPES UpdateAugust 10, 20263 updates tracked since enumeration
NPPES CertifiedAugust 10, 2026
✔ NPI 1710599543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in TN · LDC0000001425
832 MAIN ST SOUTH, Brush Creek, TN 38547
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Secondary Practice Location 1

Location 15511 Virginia Way Ste 300Brentwood, TN 37027-7611 · Phone (615) 994-1000 · Fax (615) 994-0100

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Raymond Blackwell Ladac Ii is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9931669777
PECOS Enrollment IDI20260901002782
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.

Medicare Billing Reassignment

Medicare enrollment records show Raymond Blackwell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

National Addiction Specialists LLC
51 mi
Addiction Medicine
5511 VIRGINIA WAY STE 300
Brentwood, TN 37027
  • Reassigned Medicare billing, Tennessee enrollment
  • 32 clinicians in this Medicare group
NPI 1477186336 (615) 994-9000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Raymond Blackwell's NPI number?

The NPI number for Raymond Blackwell is 1710599543. It was assigned to this individual provider in the NPPES registry on August 21, 2020.

Where is Raymond Blackwell located?

Raymond Blackwell practices at 832 Main St South, Brush Creek, TN 38547. The listed phone number is (615) 630-8908.

What is Raymond Blackwell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Raymond Blackwell enrolled in Medicare?

Yes. Raymond Blackwell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Raymond Blackwell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raymond Blackwell reassigns Medicare benefits to National Addiction Specialists LLC (Brentwood, TN). 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 Raymond Blackwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Raymond Blackwell was last updated on August 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.