NPIMap

Individual provider Active NPI

Robert Charles Blackwood, MD

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1407841968
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101051005 Issued in VA
Practice address
1201 Lake James Dr
Suite 200
Virginia Beach, VA 23464-6780
Phone
(757) 523-0022
Fax
(757) 523-5018
NPI assigned
Sep 12, 2005
Reactivated
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101051005 VA Primary

Addresses

Primary practice location

1201 Lake James Dr
Suite 200
Virginia Beach, VA 23464-6780

Mailing address

1201 Lake James Dr
Suite 200
Virginia Beach, VA 23464-6780
Phone (757) 523-0022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050215000491 VA Practitioner - Family Practice 4587616867 Reassigns benefits to 1 organization
I20250502001012 NC Practitioner - Family Practice 4587616867 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101051005VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Feb 9, 2020 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Feb 9, 2020 Accepting new patients
Cannercharles PLLC CurrentSince Dec 15, 2024 Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Nova Physician Wellness Center PLLC Family Medicine Past Accepting new patients

Locations

8644 Sudley Rd
#220
Manassas, VA 20110

1201 Lake James Dr
Ste 200
Virginia Beach, VA 23464
Phone (757) 523-0022

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: robert.blackwood.1@30512.direct.athenahealth.com

Organizations & group practices 10

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.

Hospital & facility affiliations 8

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Medical Group, LLC 1,522 clinicians

Practice addresses (Care Compare)

1129 Corolla Village Rd C
Corolla, NC 27927
Phone (252) 597-1157

1201 Lake James Dr
Suite 200
Virginia Beach, VA 23464-6780
Phone (757) 523-0022

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

  • Sentara Home Care Services-Virginia Beach Home health agency, Chesapeake, VA, CCN 497747
  • Sentara Leigh Hospital Hospital, Norfolk, VA, CCN 490046
  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120
  • Sentara Princess Anne Hospital Hospital, Virginia Beach, VA, CCN 490119
  • Sentara Virginia Beach General Hospital Hospital, Virginia Beach, VA, CCN 490057
  • The Outer Banks Hospital, Inc Hospital, Nags Head, NC, CCN 341324

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1407841968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 LAKE JAMES DR",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646780",
            "telephone_number": "757-523-0022",
            "fax_number": "757-523-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 LAKE JAMES DR",
            "address_2": "SUITE 200",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234646780",
            "telephone_number": "757-523-0022",
            "fax_number": "757-523-5018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "deactivation_date": "2006-03-22",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101051005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.