Ronald L Blackwell
Individual provider Active NPI Driver · Raleigh, NC
NPI 1053939736 · NPPES record last updated Jul 9, 2020
Key facts
- NPI
- 1053939736
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 8601 Six Forks Rd Ste 400
Raleigh, NC 27615-2965 - Phone
- (919) 280-4822
- NPI assigned
- Jul 9, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | Yes |
Addresses
Primary practice location
8601 Six Forks Rd Ste 400
Raleigh, NC 27615-2965
Mailing address
600 Copper Beech LN
Wake Forest, NC 27587-1840
Phone (252) 289-2027
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Raleigh | Direct |
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.