Active NPI
Rebecca Blackwelder, PA-C
- Medical Physician Assistant
- Largo, FL
National Provider Identifier
1508944646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA9101004
- Practice address
- 1345 W Bay Dr
Suite 101
Largo, FL 33770-2282 - Phone
- (727) 581-3550
- NPI assigned
- Nov 2, 2006
- Last updated
- May 15, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA9101004 | FL | Primary |
Addresses
Primary practice location
1345 W Bay Dr
Suite 101
Largo, FL 33770-2282
Mailing address
1345 W Bay Dr
Suite 101
Largo, FL 33770-2282
Phone (727) 581-3550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9101004 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cardiology Consultants | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Heart & Vascular Institute of Florida - South Pinellas
- Specialist
- St Petersburg, FL
- NPI 1811940802
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400112000000",
"number": "1508944646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1345 W BAY DR",
"address_2": "SUITE 101",
"city": "LARGO",
"state": "FL",
"postal_code": "337702282",
"telephone_number": "727-581-3550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 W BAY DR",
"address_2": "SUITE 101",
"city": "LARGO",
"state": "FL",
"postal_code": "337702282",
"telephone_number": "727-581-3550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELDER",
"first_name": "REBECCA",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2014-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA9101004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.