Individual provider Active NPI

Anthony Paul Blackman, D.M.D

  • General Practice Dentistry
  • Cheraw, SC
National Provider Identifier
1578825808
Registry record updated Jun 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8066 Issued in SC
Practice address
1220 Chesterfield Hwy
Cheraw, SC 29520-7014
Phone
(843) 537-4368
NPI assigned
Jun 12, 2012
Last updated
Jun 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8066 SC Primary

Addresses

Primary practice location

1220 Chesterfield Hwy
Cheraw, SC 29520-7014

Mailing address

1220 Chesterfield Hwy
Cheraw, SC 29520-7014
Phone (843) 537-4368

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8066SCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Blackman Family Dentistry General Practice 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.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339459200000",
    "number": "1578825808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207014",
            "telephone_number": "843-537-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CHESTERFIELD HWY",
            "city": "CHERAW",
            "state": "SC",
            "postal_code": "295207014",
            "telephone_number": "843-537-4368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "ANTHONY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2012-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "8066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheraw, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2012; 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.