Kendall Leon Blackwell, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

238 Issued in NC

Practice address

1704 Glendale Dr SW
Suite a
Wilson, NC 27893-4678

Phone

(252) 237-0138

Fax

(252) 237-7903

NPI assigned

Jun 9, 2006

Last updated

Aug 9, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Instride Foot and Ankle Specialists, PLLCGroup PAC ID 7012168271, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wilson Medical Center Hospital, Wilson, NC, CCN 340126

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kendall.blackwell@ifasp.eclinicaldirectplus.com

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.

• Instride Foot and Ankle Specialists, PLLC

  • Primary Podiatric Medicine Podiatrist
  • Concord, NC
  • NPI 1457601601
  Medicare reassignment Care Compare group NPD
• Wilson Podiatry Associates, PA

  • Podiatrist
  • Wilson, NC
  • NPI 1275684730
  Authorized official Same address or phone
• Instride Foot and Ankle Specialists, PLLC

  • Primary Podiatric Medicine Podiatrist
  • King, NC
  • NPI 1063390862
  NPD
• Piedmont Foot Clinic, PA

  dba Piedmont Foot & Ankle Clinic, PA

  • Primary Podiatric Medicine Podiatrist
  • Cary, NC
  • NPI 1194783233
  NPD (past)

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

• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • General Acute Care Hospital
  • Wilson, NC
  • NPI 1215359922
  Care Compare affiliation
• DLP Wilson Medical Center LLC

  dba Wilson Medical Center

  • Psychiatric Hospital Unit
  • Wilson, NC
  • NPI 1386196459
  Care Compare affiliation

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1366483638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934678",
            "telephone_number": "252-237-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 GLENDALE DR SW",
            "address_2": "SUITE A",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934678",
            "telephone_number": "252-237-0138",
            "fax_number": "252-237-7903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "KENDALL",
        "middle_name": "LEON",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "238",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NC",
            "license": "238",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NC",
            "license": "238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Ellis Biermann
• Sarah Elizabeth Kirby Bischoff, RPH
• Kristen M Bissette, OTRL
• Malisha Bissette, RPH.
• Clarisa Renee Blackwell, LMBT, MMP
• Jennifer Blake
• Ashley Johnson Blalock
• Deborah Blalock
• Nikolas Bland
• Blooming Beginnings PLLC

• Primary Podiatric Medicine Podiatrist in Wilson, NC
• Providers in Wilson, NC by specialty
• Primary Podiatric Medicine Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.