Ruby Amanda Stipe Blaylock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001006690 Issued in NC

Practice address

4205 Ben Franklin Blvd
Durham, NC 27704-2143

Phone

(919) 477-6900

Fax

(919) 620-0974

NPI assigned

Jul 30, 2015

Last updated

Feb 28, 2025By the provider in NPPES

Sex

Female

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

• Ruby Amanda Stipe Former name

Medicare fee-for-service enrollment

Enrolled in NC, GA2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Millennium Physician Group of NC, PLLCGroup PAC ID 2567593635, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: ruby.amanda.blaylock.1@27061.direct.athenahealth.com
• Direct secure messaging: rubyamandablaylock@arhs.allscriptsdirect.net

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.

• Millennium Physician Group of NC, PLLC

  • Internal Medicine Physician
  • Durham, NC
  • NPI 1073832812
  Medicare reassignment Care Compare group
• Appalachian Regional Medical Associates, Inc.

  dba Appalachian Gastroenterology

  • Family Medicine Physician
  • Boone, NC
  • NPI 1669533923
  Medicare reassignment
• Wake Forest Emergency Providers

  • Multi-Specialty Clinic/Center
  • Statesville, NC
  • NPI 1396216735
  Medicare reassignment
• Integrity Health and Wellness, LLC

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1881181808
  Medicare reassignment
• Medspring of Texas, PA

  dba MedSpring Urgent Care

  • Urgent Care Clinic/Center
  • Buda, TX
  • NPI 1629551114
  NPD (past)
• Medspring of Texas, PA

  dba MedSpring

  • Urgent Care Clinic/Center
  • Austin, TX
  • NPI 1811286354
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1184000234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-599-2612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 BEN FRANKLIN BLVD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042143",
            "telephone_number": "919-477-6900",
            "fax_number": "919-620-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAYLOCK",
        "first_name": "RUBY AMANDA",
        "middle_name": "STIPE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001006690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUBY",
            "last_name": "STIPE",
            "middle_name": "AMANDA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lindsey Allsbrook Blanton, LCSW
• Lynn Blass, MFT
• Vicki Blatt
• Brent Lashley Blaylock, DDS
• Laveta Blaylock, LMFT
• Melinda F. Blazar, PA
• Dan Blazer, MD
• Dan German Blazer III, M.D.
• Michael August Blazing, MD
• Kelly Hill Blessing, FNP C

• Physician Assistant in Durham, NC
• Providers in Durham, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.