NPI age
19 years
Enumerated 2006-06-06
● Active
Type 1 · Individual
MR. Jonathan Blackmon, IDC
Blackmon is 1 of 6 military health care provider providers in Saint Marys and 1 of 45 in Georgia.
Primary specialty
Military Health Care Provider
Plus 1 subspecialty
Licensed in
—
0 states
Status
Active
No deactivations on record
Last NPPES update
2021-08-12
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 45 active military health care provider providers in Georgia.
NPI age
19 years
≈ at median (18 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
1
In the 4% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-06Enumerated in NPPES
2006
2026
Where they practice
Practice location
603 Wild Grape Dr
Saint Marys, GA 315583619
Mailing address
881 Uss James Madison Rd, Naval Submarine Support Center Medical Department
Kings Bay, GA 315472531
Specialties
-
Military Health Care Provider PrimaryA Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical...
-
Specialist/Technologist, PathologyDefinition to come...
Practice context
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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