Active NPI
Billy R Blackwell, M. D.
- Contractor
- Florence, SC
National Provider Identifier
1689907784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 4914
- Practice address
- 907 Santee Dr
Florence, SC 29501-5737 - Phone
- (843) 669-0423
- NPI assigned
- Sep 8, 2009
- Last updated
- Sep 8, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 4914 | SC | Primary |
Addresses
Primary practice location
907 Santee Dr
Florence, SC 29501-5737
Mailing address
907 Santee Dr
Florence, SC 29501-5737
Phone (843) 669-0423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4914 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1689907784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "907 SANTEE DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295015737",
"telephone_number": "843-669-0423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "907 SANTEE DR",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295015737",
"telephone_number": "843-669-0423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "BILLY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-08",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Contractor",
"state": "SC",
"license": "4914",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; 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.