NPI age
20 years
Enumerated 2005-10-04
● Active
Type 1 · Individual
Shawna C Blackmon, PA
Blackmon is 1 of 14 physician assistant providers in Nacogdoches and 1 of 11022 in Texas.
Primary specialty
Physician Assistant
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-02-24
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 11022 active physician assistant providers in Texas.
NPI age
20 years
↑ 10 yr above median (10 yr)
State licenses
1 state
7% of peers hold multiple states
Subspecialties
1
In the 23% of peers with subspecialties
NPI lifetime · 2005 → 2026
2005-10Enumerated in NPPES
2005
2026
Where they practice
Practice location
3816 N University Dr
Nacogdoches, TX 759652011
Mailing address
3414 Golden Rd
Tyler, TX 757018336
Additional practice locations
1 secondary location on file with NPPES.
Location 2
3414 Golden Rd
Tyler, TX 757018336
Specialties
-
Physician Assistant PrimaryA 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...
-
Physician AssistantDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | P00743048 | RAILROAD MEDICARE |
| 01 (TX) | 8360ND | BLUE CROSS BLUE SHIELD |
| 05 (TX) | 206265503 | |
| 05 (TX) | 206265502 | |
| 05 (TX) | 206265504 | |
| 05 (TX) | 206265501 | |
| 01 (TX) | 8Y8693 | BCBS |
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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