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

Lee Blackmon

Individual provider Psychiatry Physician · NPI 1417489774

Lee Blackmon is a Psychiatry in Jacksonville, Florida. Graduated from Medical University of South Carolina College of Medicine in 2017, 9 years ago. Practices with Bon Secours Medical Group Greenville Specialty Care LLC, a 289-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida, North Carolina and South Carolina.

Years since qualifying
9
Trained at
Medical University of South Carolina College of Medicine
Licensed in
FL, NC, SC
In the registry since
2017
Specialties on file
4
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Practice location Address checks out

580 W 8th St 6th Fl Ste 6005
Jacksonville, FL 32209-6533
Phone: (904) 244-3990
Fax: (904) 244-3455
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 202100603 (NC)
Psychiatry Physician Taxonomy 2084P0800X · Licence 86392 (SC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence TRN24684 (FL)

Record details

NPI number1417489774
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 28, 2017
Last updated in NPPESSeptember 29, 2021
Certification dateSeptember 29, 2021
Mailing address5003 S Miami Blvd, Ste 300, Durham, NC 27703-8589

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolMEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Bon Secours Medical Group Greenville Specialty Care Llc — 289 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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