Individual provider Active NPI

Michelle Rae Blair, NP-C

  • Family Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1104489111
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
24897 Issued in SC
Practice address
8161 Warren H Abernathy Hwy
Spartanburg, SC 29301-2451
Phone
(864) 586-1152
NPI assigned
Apr 16, 2019
Reactivated
Jun 3, 2019
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024177529 VA
Family Nurse Practitioner 363LF0000X 24897 SC Primary

Addresses

Primary practice location

8161 Warren H Abernathy Hwy
Spartanburg, SC 29301-2451

Mailing address

PO Box 639917
Cincinnati, OH 45263-9917

Other identifiers 5

IdentifierTypeStateIssuer
SCK1056067OtherSCMEDICARE PIN
SCK1055019OtherSCMEDICARE PIN
SCK105J577OtherSCMEDICARE PIN
SCK1056084OtherSCMEDICARE PIN
NP7525MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518001066 SC Practitioner - Nurse Practitioner 3476882358 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bon Secours Ambulatory Services - St. Francis, LLCGroup PAC ID 0840590931, 57 clinicians

Practice addresses (Care Compare)

1467 Woodruff Rd
Suite C
Greenville, SC 29607-6505
Phone (864) 458-8126

1494 W Wade Hampton Blvd
Suite C
Greer, SC 29650-1166
Phone (864) 849-8999

2746 Boiling Springs Rd
Boiling Springs, SC 29316-6003
Phone (864) 757-5059

8161 Warren H Abernathy Hwy
Spartanburg, SC 29301-2451
Phone (864) 757-5059

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours Ambulatory Services - St. Francis, LLC CurrentSince Oct 23, 2023 Accepting new patients
Cherokee Medical Center CurrentSince May 1, 2021 Accepting new patients
Cherokee Medical Center Current Accepting new patients
Spartanburg Medical Center CurrentSince Nov 1, 2021 Accepting new patients
Woodruff Road Urgent Care Center, P.C. CurrentSince Jan 7, 2024 Accepting new patients
Spartanburg Medical Center Current Accepting new patients
Cherokee Medical Center CurrentSince May 1, 2021 Accepting new patients

Locations

840 W Floyd Baker Blvd
Gaffney, SC 29341
Phone (864) 489-3300

1467 Woodruff Rd
Ste C
Greenville, SC 29607
Phone (864) 458-8126

101 E Wood St
Spartanburg, SC 29303
Phone (864) 560-1915

101 E Wood St
Ste 300
Spartanburg, SC 29303
Phone (864) 560-6554

8161 Warren H Abernathy Hwy
Spartanburg, SC 29301
Phone (864) 215-3729

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1104489111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639917",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452639917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8161 WARREN H ABERNATHY HWY",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293012451",
            "telephone_number": "864-586-1152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "MICHELLE",
        "middle_name": "RAE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "deactivation_date": "2019-05-02",
        "reactivation_date": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024177529",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "24897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCK1056067",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCK1055019",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCK105J577",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCK1056084",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP7525",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.