Charles Philip Blackshear, M.D.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Practice address

4949 Stevens Creek Blvd
Santa Clara, CA 95051-6661

Phone

(408) 260-2273

NPI assigned

May 5, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553731200000",
    "number": "1114362175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1389 JEFFERSON ST UNIT A507",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946121670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 STEVENS CREEK BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950516661",
            "telephone_number": "408-260-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSHEAR",
        "first_name": "CHARLES",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-05",
        "last_updated": "2019-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Bisnar, MSW
• Laily Biswas
• Nancy A. Bitar-Godfrey, MD
• Susan Jane Bjerrum, PT
• Michael Black
• Laura Blackwell, NP
• Brian A Blaugrund, MD
• Sandra Jones Blinn, LCSW
• Madison Blitz
• Bloom USA

• Urgent Care Clinic/Center in Santa Clara, CA
• Providers in Santa Clara, CA by specialty
• Urgent Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.