Blair Funk, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61422193 Issued in WA

Practice address

21731 N 77TH Ave Ste 1300
Peoria, AZ 85382-2109

Phone

(002) 338-3264

Fax

(623) 561-3305

NPI assigned

Apr 28, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, AZ, NC3 enrollments

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 3

Specialty

Family Practice

Education

University of Miami, LM Miller School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Primary Care Professional Services,LLCGroup PAC ID 9638343924, 313 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Merit-based Incentive Payment System (MIPS)

Final score

81.56 of 100Reported as group

Quality

80.73

Promoting interoperability

80

Improvement activities

40

Cost

74.47

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bfunk28280@evernorth.direct-ci.com
• Direct secure messaging: bfunk2978355@carolinashealthcaresystem.direct-ci.com

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.

• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment Care Compare group NPD
• Carolinas Physicians Network Inc

  dba The Sanger Clinic

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment NPD
• Osh-Mi Physicians Group PC

  • Family Medicine Physician
  • Greensboro, NC
  • NPI 1033766092
  Medicare reassignment NPD
• Cigna Health Care of Arizona Inc.

  dba CMG Clyde Wright Urgent Care, CMG Clyde Wright AHC, Phoenix Central UC

  • Urgent Care Clinic/Center
  • Phoenix, AZ
  • NPI 1245338235
  NPD
• Cigna Health Care of Arizona Inc.

  dba Clyde Wright Center, CMG Phx Central MultiSpec Cntr

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1942371679
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes Prevention

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Primary Care North Charlotte Internal Medicine

  • Internal Medicine Physician
  • Huntersville, NC
  • NPI 1730362641
  NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Osh Mi Physicians Group, PC

  • Primary Care Clinic/Center
  • Memphis, TN
  • NPI 1720635790
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1326493289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 BUFORD HWY",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305183665",
            "telephone_number": "770-945-1699",
            "fax_number": "770-945-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21731 N 77TH AVE STE 1300",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822109",
            "telephone_number": "002-338-3264",
            "fax_number": "623-561-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 Buford Hwy",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305183665",
            "country_code": "US",
            "telephone_number": "770-945-1699",
            "fax_number": "770-945-1698",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 N 12th St Ste 404",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850062866",
            "country_code": "US",
            "telephone_number": "800-233-3264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUNK",
        "first_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-28",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61422193",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2024-01311",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "58464",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "81892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Douglas R Gabriel, DDS
• Elizabeth Gaddam

• Family Medicine Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.