NPIMap

Individual provider Active NPI

Hayley Blackwell, PA-C

  • Physician Assistant
  • Sweetwater, TX
National Provider Identifier
1619042009
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05094 Issued in TX
Practice address
201 E Arizona Ave
Sweetwater, TX 79556-7119
Phone
(325) 235-8641
Fax
(325) 235-5925
NPI assigned
Nov 21, 2006
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05094 TX Primary
Medical Physician Assistant 363AM0700X TX

Addresses

Primary practice location

201 E Arizona Ave
Sweetwater, TX 79556-7119

Mailing address

201 E Arizona Ave
Sweetwater, TX 79556-7119
Phone (325) 235-8641

Other identifiers 1

IdentifierTypeStateIssuer
194634501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080606000360 TX Practitioner - Physician Assistant 4981774643 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scurry County Hospital DistrictGroup PAC ID 7012987589, shared by 4 NPIs, 21 clinicians

Practice addresses (Care Compare)

1700 Cogdell Blvd
Snyder, TX 79549-6162
Phone (325) 574-7439

1700 Cogdell Blvd
Snyder, TX 79549-6198
Phone (325) 574-7439

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scurry County Hospital District CurrentSince Sep 1, 2023 Accepting new patients
Scurry County Hospital District CurrentSince Jul 1, 2025 Accepting new patients
Scurry County Hospital District CurrentSince Sep 1, 2023 Accepting new patients
Stonewall Memorial Hospital Past Accepting new patients
Scurry County Hospital District Past Accepting new patients
Privia Medical Group West Texas, PLLC Past Accepting new patients
Camino Real Emergency Physicians PLLC Physician Assistant Past Accepting new patients

Locations

1700 Cogdell Blvd
Snyder, TX 79549
Phone (325) 573-6374

Organizations & group practices 9

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1619042009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E ARIZONA AVE",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795567119",
            "telephone_number": "325-235-8641",
            "fax_number": "325-235-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E ARIZONA AVE",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795567119",
            "telephone_number": "325-235-8641",
            "fax_number": "325-235-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "HAYLEY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05094",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194634501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sweetwater, TX

Sources for this page

Verify at the official NPI Registry.