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

Jordon Blackmon, PA-C

Individual provider Surgical Physician Assistant · NPI 1407640725

Jordon Blackmon, PA-C is a Physician Assistant in Lawrenceville, Georgia. Graduated from Philadelphia College of Osteopathic Medicine in 2024, 2 years ago. Practices with Advanced Urology Institute of Georgia, a 56-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
2
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
GA
In the registry since
2025
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

501 Crown Pointe Way
Lawrenceville, GA 30046
Phone: (678) 344-8900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 12984 (GA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 12984
Physician Assistant Taxonomy 363A00000X · Licence 12984 (GA)

Record details

NPI number1407640725
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 9, 2025
Last updated in NPPESApril 28, 2025
Certification dateApril 28, 2025
Mailing address1551 Janmar Rd, Snellville, GA 30078-5606

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2024 (2 years in practice)
Group practice Advanced Urology Institute Of Georgia — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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