Benjamin P Blakeman, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

29069 Issued in SC

Practice address

3621 Randolph Rd Ste 100
Charlotte, NC 28211-0027

Phone

(704) 512-3303

NPI assigned

Sep 3, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ben Blakeman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1725321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1063247948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 SAVILE LN",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297157800",
            "telephone_number": "704-564-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 RANDOLPH RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110027",
            "telephone_number": "704-512-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKEMAN",
        "first_name": "BENJAMIN",
        "middle_name": "P",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-03",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "29069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BEN",
            "last_name": "BLAKEMAN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rory Blake
• Ross Blake, DPT
• Sarah Blake, PA
• Amber Blakely Cabbil, BCBA
• Vonetta Butler Blakely, LCSW
• Blakeney Behavioral Health LLC
• Blakeney Counseling & Consulting Services LLC
• Blakeney Counseling & Wellness LLC.
• Blakeney Family Chiropractic
• Blakeney Family Practice, PLLC

• Acute Care Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Acute Care Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.