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Deactivated NPI 1497759872 Deactivated / Inactive NPI Male Practitioner

Bobby Blackmon , PA

Physician Assistant • Rockledge, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Bobby Blackmon has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 13, 2005
NPI Deactivation Date December 13, 2022
Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Bobby Blackmon, PA was a registered Physician Assistant practicing in Rockledge, FL. Throughout an active medical career spanning 17 years, Bobby Blackmon provided care at the practice location at 110 LONGWOOD AVE until profile deactivation on 2022-12-13.

Practice Location & Contact Primary Location

Practice Address

110 Longwood Ave

Rockledge, FL 329552828

Telephone 8004768646
Fax 9193823210
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Rockledge, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.2 Yrs
State Avg: 11.1 Yrs
Regional Practice Density
18 Specialists

Practicing in Rockledge, FL (10376 Statewide)

Telehealth Adoption Rate
5.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License FL PA2052

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

29 Associated Practitioners
Dr. Currin Nichol , MD

Emergency Medicine

NPI 1013919299

Doctor of Medicine (M.D.)

Dr. Milton Smith , MD

Emergency Medicine

NPI 1033160163

Doctor of Medicine (M.D.)

Daniel Daniels , PA

Physician Assistant

NPI 1134121445

Physician Assistant

Dr. Matthew Wells , MD

Emergency Medicine

NPI 1144272790

Doctor of Medicine (M.D.)

Deven Metzger , PA

Physician Assistant

NPI 1154323459

Physician Assistant

Dr. Danny Redman , MD

Emergency Medicine

NPI 1194709113

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 13, 2022

Record deactivated on December 13, 2022

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 110 LONGWOOD AVE, ROCKLEDGE, FL 329552828 (Tel: 8004768646)

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Updated Business Mailing Address July 09, 2007

Registered at PO BOX 30731, TAMPA, FL 336303731 (Tel: 8004768646)

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Provider Name / Credentials Updated July 09, 2007

Recorded as BOBBY BLACKMON, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Physician Assistant (License #PA2052 in FL)

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Initial NPI Registration & Enumeration June 13, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1497759872
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 13, 2005
Last Update: July 09, 2007
Deactivation Date: December 13, 2022

Mailing Address

Po Box 30731

Tampa, FL 336303731

Phone: 8004768646

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.