Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jeremy Ty Blackwell, MD

Individual provider Family Medicine Physician · NPI 1205053352

Jeremy Ty Blackwell, MD is a Family Practice in Jasper, Alabama. Graduated from University of Alabama School of Medicine in 2005, 21 years ago. Practices with Walker Medical Diagnostics, LLC, a 10-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
21
Trained at
University of Alabama School of Medicine
Licensed in
AL
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1450 Jones Dairy Rd Bldg 900
Jasper, AL 35501-6108
Phone: (205) 387-8159
Fax: (205) 387-8262
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 27715 (AL)

Record details

NPI number1205053352
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 19, 2007
Last updated in NPPESFebruary 1, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF ALABAMA SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Walker Medical Diagnostics, Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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