Dina Dawson Blackstock, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001206 Issued in VA

Practice address

2091 Langhorne Rd
Lynchburg, VA 24501-1428

Phone

(434) 947-3954

Fax

(877) 583-4046

NPI assigned

Apr 18, 2007

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19847/brand/3/csg/21/fhir/r4

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

• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480
  Medicare reassignment NPD
• Monogram Health Professional Services PC

  • Nephrology Physician
  • Brentwood, TN
  • NPI 1134739089

  Physician Assistant, VA

  Medicare reassignment NPD
• Lynchburg Nephrology Physicians PLLC

  dba Lynchburg Nephrology Physicians

  • Specialist
  • Lynchburg, VA
  • NPI 1053498071
  Medicare reassignment
• Centra Medical Group, LLC

  • Family Medicine Physician
  • Lynchburg, VA
  • NPI 1649228966
  NPD
• Danville Physician Practices LLC

  dba SOVAH Physician Practices

  • Anesthesiology Physician
  • Danville, VA
  • NPI 1629022868

  Physician Assistant

  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Danville Physician Practices LLC

  • Diagnostic Radiology Physician
  • Danville, VA
  • NPI 1265243612
  NPD (past)

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1215153127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2489",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245516489",
            "telephone_number": "434-382-1139",
            "fax_number": "434-525-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 LANGHORNE RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245011428",
            "telephone_number": "434-947-3954",
            "fax_number": "877-583-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTOCK",
        "first_name": "DINA",
        "middle_name": "DAWSON",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PROVIDER NUMBER",
            "identifier": "P00451415",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Marie Black
• Melanie Marie Blackman
• William A Blackman, M.D.
• William R Blackman, M.D.
• Jeremy Blackshire, MA, LPC, LMHP, LSATP
• Mary Clayton Blackwell, LPC
• Kenneth Ross Blanchard, LPC
• Mark Edward Blanchette, DDS, MS
• Jeremiah Blankenship, PT
• Kourtnie Briann Blankenship

• Physician Assistant in Lynchburg, VA
• Providers in Lynchburg, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.