Shawn Michael Blair, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0110001382 Issued in VA

Practice address

9 Manhattan Square
Suite a
Hampton, VA 23666

Phone

(757) 838-6335

Fax

(757) 838-0612

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD (past)

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320192000000",
    "number": "1598735581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 MEREDITH WAY",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236061180",
            "telephone_number": "757-930-0409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MANHATTAN SQUARE",
            "address_2": "SUITE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "23666",
            "telephone_number": "757-838-6335",
            "fax_number": "757-838-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "SHAWN",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2011-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerri Beth Black, B.ED; M.ED
• Masai A Black, LPC
• Scott Jeffrey Black, DPT
• Christine Blair-Wallace
• Charity J Blair, CCC-SLP
• Amanda Pagels Blalock
• Julian Blalock Jr., MD
• Paul Henry Blalock Jr., RDN
• Margaret V Blanchard, MD
• Heidi Marie Blaski, DNP FNP-C

• Physician Assistant in Hampton, VA
• Providers in Hampton, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.