Leigh Fylstra Blalock, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

2010-02032 Issued in NC

Practice address

1901 N Harrison Ave
Suite 100
Cary, NC 27513-2410

Phone

(919) 677-0113

NPI assigned

Dec 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• 3-C Family Services

  • Clinical Psychologist
  • Cary, NC
  • NPI 1629447685
  NPD (past)
• 3-C Family Services, .P.a

  • Child & Adolescent Psychiatry Physician
  • Morrisville, NC
  • NPI 1295756484
  NPD (past)

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1528241569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N HARRISON AVE",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132410",
            "telephone_number": "919-677-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N HARRISON AVE",
            "address_2": "SUITE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275132410",
            "telephone_number": "919-677-0113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "LEIGH",
        "middle_name": "FYLSTRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NC",
            "license": "2010-02032",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "135213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Wayne Blake, MBA, MC
• Hunter Christian Blake, LCMHCA
• Jacklyn Michele Blake, LCMHC, MBA
• Sharon F Blakeslee
• Freddie L Blakley II
• David Randall Blanchard, RPH, CPP
• Tomika A Bland
• Chelsea M Blango
• Celeste Rachel Blankenship, MS, PT
• Erin C Blankenship, DPT, OCS, CSCS

• Child & Adolescent Psychiatry Physician in Cary, NC
• Providers in Cary, NC by specialty
• Child & Adolescent Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2011; 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.