Brian B Blackburn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

29531 Issued in NC

Practice address

146 Medical Park Rd
Ste 106
Mooresville, NC 28117-8528

Phone

(704) 664-5131

Fax

(704) 664-7547

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC, AL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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 Medicine Associates LLC

  • Hospitalist Physician
  • Baton Rouge, LA
  • NPI 1093758781

  AL, Internal Medicine

  Medicare reassignment NPD
• Hospital Physician Services - Southeast Professional Corporation

  • Hospitalist Physician
  • Monroe, GA
  • NPI 1760410385

  NC

  Medicare reassignment NPD
• Inpatient Consultants of Alabama, Inc

  • Internal Medicine Physician
  • Mobile, AL
  • NPI 1235238916
  Medicare reassignment NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1568405520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD",
            "address_2": "STE 106",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178528",
            "telephone_number": "704-664-5131",
            "fax_number": "704-664-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 MEDICAL PARK RD",
            "address_2": "STE 106",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178528",
            "telephone_number": "704-664-5131",
            "fax_number": "704-664-7547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "BRIAN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "29531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7915979",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond Joseph Biersbach, M.D.
• Linda Carol Bird, MSW
• Delina Harsha Bishop, MD
• Sarah Elizabeth Bishop, LPCA
• BJ'S Wholesale Club Inc.
• Gisela Blake
• Brianna Blankenbicker, RN, IBCLC, ICCE
• Erin Blevins
• Bryan Drew Blitstein, MD
• Blitz Chiropractic PLLC

• Internal Medicine Physician in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.