Thomas Matthew Blackwell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9604 Issued in SC

Practice address

805 W Georgia Rd
Simpsonville, SC 29680-6213

Phone

(864) 757-1500

NPI assigned

Mar 28, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pelham Links of Simpsonville, LLC

  dba Pelham Links Family & Cosmetic Dentistry, PA

  • General Practice Dentistry
  • Greer, SC
  • NPI 1588962567
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1013478288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 W GEORGIA RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806213",
            "telephone_number": "864-757-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 W GEORGIA RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296806213",
            "telephone_number": "864-757-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "THOMAS",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-28",
        "last_updated": "2022-03-23",
        "certification_date": "2021-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mblackwell@pelhamlinks.com",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "805 W Georgia Rd",
            "city": "Simpsonville",
            "state": "SC",
            "country_code": "US",
            "postal_code": "296806213",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sonja Rena Black, RN
• Daniel Blackmon
• Connie J Blackstone, MD
• Marcus E Blackstone, MD
• Thomas Harold Blackwell, MD
• Lindsay Blair
• Christina L Blake, NP
• Haley Elise Blake, FNP-BC
• Amanda Blanton
• Benjamin Allen Blanton, DPT

• General Practice Dentistry in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.