Barry C Blackston, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

16698 Issued in SC

Practice address

8 Memorial Medical CT
Ste 4
Greenville, SC 29605-4400

Phone

(864) 242-5678

Fax

(864) 242-5679

NPI assigned

Aug 3, 2005

Sex

Male

Sole proprietor

Yes

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 SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Gim Barry Blackston, MD, PA

  • Internal Medicine Physician
  • Greenville, SC
  • NPI 1689193237
  NPD Authorized official
• Regency Hospital of Greenville, LLC

  • Long Term Care Hospital
  • Anderson, SC
  • NPI 1396747929
  Medicare reassignment

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1316948185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT",
            "address_2": "STE 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054400",
            "telephone_number": "864-242-5678",
            "fax_number": "864-242-5679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEMORIAL MEDICAL CT",
            "address_2": "STE 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054400",
            "telephone_number": "864-242-5678",
            "fax_number": "864-242-5679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTON",
        "first_name": "BARRY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "16698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3048",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Lynn Black, NP
• Teonna Black
• Corinne Blackmon, MA, LCMHC, LPC
• Kevin Neely Blackmon, M.D.
• Charlaina Blackstock
• Alice Blackwell, M.ED, E.DS., LPC-A
• Andrea K Blackwell, LCSW
• Ann Kathryn Blackwell, RN
• Caitlin Alexandria Blackwell, MD STUDENT
• Hanna Blackwell, RBT

• Internal Medicine Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Internal Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.