NPIMap

Organization Active NPI

William S Blakemore MD LTD

  • Ophthalmology Physician
  • Edenton, NC
National Provider Identifier
1477507994
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
24730 Issued in NC
Legal business name
WILLIAM S BLAKEMORE MD LTD
Practice address
101 Mark Dr
Edenton, NC 27932-1704
Phone
(252) 482-7471
Fax
(252) 482-5465
NPI assigned
May 20, 2006
Last updated
Feb 3, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Dr. William S Blakemore, M.D.NPI 1235195827
Title
President Corp.
Phone
(252) 482-7471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 24730 NC Primary

Addresses

Primary practice location

101 Mark Dr
Edenton, NC 27932-1704

Mailing address

101 Mark Dr
Edenton, NC 27932-1704
Phone (252) 482-7471

Other identifiers 3

IdentifierTypeStateIssuer
0131VOtherNCBLUE CROSS GROUP NUMBER
890131VMedicaidNC
CG5520OtherNCRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

101 Mark Dr
Edenton, NC 27932
Phone (252) 482-7471

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1477507994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321704",
            "telephone_number": "252-482-7471",
            "fax_number": "252-482-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MARK DR",
            "city": "EDENTON",
            "state": "NC",
            "postal_code": "279321704",
            "telephone_number": "252-482-7471",
            "fax_number": "252-482-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM S BLAKEMORE MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "BLAKEMORE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT CORP.",
        "authorized_official_telephone_number": "252-482-7471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "24730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "0131V",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890131V",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG5520",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edenton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.