Blake Coffman
Blake Coffman is a Nurse Practitioner in Jackson, TN, registered under NPI 1578262192. This provider registers 8 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 64 PALMER DR, Jackson, TN 38305. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 35606 | TN | Nurse Practitioner primary |
| 0024195588 | VA | Emergency Medicine Physician |
| 0024195588 | VA | Physical Medicine & Rehabilitation… |
| 0024195588 | VA | Internal Medicine Physician |
| 0024195588 | VA | Family Medicine Physician |
| 35606 | TN | Diagnostic Radiology Physician |
| 35606 | TN | Surgery Physician |
| 35606 | TN | Emergency Medicine Physician |
| 0024195588 | VA | Pediatrics Physician |
| 35606 | TN | Physical Medicine & Rehabilitation… |
| 35606 | TN | Pediatrics Physician |
| 35606 | TN | Family Medicine Physician |
| 35606 | TN | Internal Medicine Physician |
| 0024195588 | VA | Diagnostic Radiology Physician |
| 0024195588 | VA | Surgery Physician |
Licences are recorded in 2 states: TN, VA. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
- Status
- Approved
- Provider type
- Practitioner - Nurse Practitioner
- PAC ID
- 0749795011
- Enrollment ID
- I20250715003423
Medicare enrolment is recorded as approved under the provider type Practitioner - Nurse Practitioner. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
Licensed in 2 states
This provider holds licences in 2 states: Tennessee and Virginia. The practice address on file is in Jackson, TN, but a licence in another state usually means they see patients there too — either at a second location or by telehealth. If the address above is far from you, it is worth calling to ask whether they practise closer to where you live.
Licence numbers are self-reported to NPPES at registration. They do not confirm a licence is currently active, in good standing, or valid for the specialty shown — only the state board can tell you that, which is why we link to each one.
What Nurse Practitioner covers
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. NUCC Health Care Provider Taxonomy, code 363L00000X
All registered taxonomy codes
This provider registers 15 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 35606 | TN | primary |
| 207P00000X | Emergency Medicine Physician | 0024195588 | VA | |
| 208100000X | Physical Medicine & Rehabilitation Physician | 0024195588 | VA | |
| 207R00000X | Internal Medicine Physician | 0024195588 | VA | |
| 207Q00000X | Family Medicine Physician | 0024195588 | VA | |
| 2085R0202X | Diagnostic Radiology Physician Diagnostic Radiology | 35606 | TN | |
| 208600000X | Surgery Physician | 35606 | TN | |
| 207P00000X | Emergency Medicine Physician | 35606 | TN | |
| 208000000X | Pediatrics Physician | 0024195588 | VA | |
| 208100000X | Physical Medicine & Rehabilitation Physician | 35606 | TN | |
| 208000000X | Pediatrics Physician | 35606 | TN | |
| 207Q00000X | Family Medicine Physician | 35606 | TN | |
| 207R00000X | Internal Medicine Physician | 35606 | TN | |
| 2085R0202X | Diagnostic Radiology Physician Diagnostic Radiology | 0024195588 | VA | |
| 208600000X | Surgery Physician | 0024195588 | VA |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1578262192 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Mar 2, 2023 |
| Last updated | Apr 24, 2026 |
| Status | Active |
| Sole proprietor | Yes |
| Practice address |
64 PALMER DR Jackson, TN 38305 (731) 614-0728 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 5 | 7 | 8 | 2 | 6 | 2 | 1 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 5 | 5 | 8 | 4 | 6 | 4 | 1 | 9 |
Sum = 68 · next multiple of 10 = 70 · check digit = 2 · actual last digit = 2
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.