Fair Bluff Medical Clinic PLLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

FAIR BLUFF MEDICAL CLINIC PLLC

Practice address

12291 Andrew Jackson Hwy SW
Fair Bluff, NC 28439-9597

Phone

(910) 207-2714

NPI assigned

Jun 16, 2025

Organization subpart

No

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

Authorized official

Name

Elizabeth Paige Blackwell, NP

Title

Owner

Phone

(910) 374-0722

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Paige Barnhill-Blackwell, FNP-C

  • Family Nurse Practitioner
  • Fair Bluff, NC
  • NPI 1386275006
  Medicare reassignment NPD

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756252800000",
    "number": "1699661652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12291 ANDREW JACKSON HWY SW",
            "city": "FAIR BLUFF",
            "state": "NC",
            "postal_code": "284399597",
            "telephone_number": "910-207-2714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12291 ANDREW JACKSON HWY SW",
            "city": "FAIR BLUFF",
            "state": "NC",
            "postal_code": "284399597",
            "telephone_number": "910-207-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR BLUFF MEDICAL CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-374-0722",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DBG III LLC (Fair Bluff Assisted Living #2)
• DBG III LLC (Fair Bluff Assisted Living #1)
• Elvington Drug LLC (Elvington Drug)
• Fair Bluff Discount Drug, Inc
• Fair Bluff Fire Department and Rescue Squad, Inc
• Leah Jordan Floyd
• Angiala Mia Guilmette
• Hope Advancement Inc.
• Klaudia Kowalkowska
• Leonard R Odham Jr DDS PA

• Nurse Practitioner in Fair Bluff, NC
• Providers in Fair Bluff, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.