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

Willett Blake Coffman

Individual provider Emergency Medicine Physician · NPI 1578262192

Willett Blake Coffman is a Nurse Practitioner in Jackson, Tennessee. Qualified in 2023, 3 years ago. Practices with Lexington Clinic Corp, a 22-clinician group, works from 5 locations and accepts Medicare assignment. Licensed in Tennessee and Virginia.

Years since qualifying
3
Licensed in
TN, VA
In the registry since
2023
Specialties on file
15
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Practice location Address checks out

64 Palmer Dr
Jackson, TN 38305-8029
Phone: (731) 614-0728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 2545 N Washington Ave, Brownsville, TN 38012-1687 — (731) 307-3777
  • 5001 E Main St, Erin, TN 37061-4115 — (931) 289-4158
  • 200 W Church St, Lexington, TN 38351-2038 — (731) 968-3646
  • 18688 Jeb Stuart Hwy, Stuart, VA 24171-1559 — (276) 692-9020

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 35606 (TN)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 0024195588 (VA)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 0024195588 (VA)
Internal Medicine Physician Taxonomy 207R00000X · Licence 0024195588 (VA)
Pediatrics Physician Taxonomy 208000000X · Licence 0024195588 (VA)
Family Medicine Physician Taxonomy 207Q00000X · Licence 0024195588 (VA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 35606 (TN)
Surgery Physician Taxonomy 208600000X · Licence 35606 (TN)
Emergency Medicine Physician Taxonomy 207P00000X · Licence 35606 (TN)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 35606 (TN)
Pediatrics Physician Taxonomy 208000000X · Licence 35606 (TN)
Family Medicine Physician Taxonomy 207Q00000X · Licence 35606 (TN)
Internal Medicine Physician Taxonomy 207R00000X · Licence 35606 (TN)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0024195588 (VA)
Surgery Physician Taxonomy 208600000X · Licence 0024195588 (VA)

Record details

NPI number1578262192
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 2, 2023
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026
Mailing address64 Palmer Dr, Jackson, TN 38305-8029

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Lexington Clinic Corp — 22 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Jackson