Darrell Kevin Blackwell, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

0102050073 Issued in VA

Practice address

1490 Park Ave NW
Suite 5
Norton, VA 24273-1631

Phone

(276) 439-1440

Fax

(276) 439-1441

NPI assigned

Sep 28, 2006

Last updated

Jan 27, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

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.

• Norton Community Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Norton, VA
  • NPI 1295955367
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485475200000",
    "number": "1710079819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 PARK AVE NW",
            "address_2": "SUITE 5",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731631",
            "telephone_number": "276-439-1440",
            "fax_number": "276-439-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 PARK AVE NW",
            "address_2": "SUITE 5",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731631",
            "telephone_number": "276-439-1440",
            "fax_number": "276-439-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "DARRELL",
        "middle_name": "KEVIN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2017-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "VA",
            "license": "0102050073",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0102050073",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710079819",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Berneau, DO
• Jessalyn Berry, DO
• Ashley Reba Bevins, D.O.
• Bio-Medical Applications of Virginia, Inc. (Mountain Empire Dialysis Center)
• Zachary Neil Blackmon, DO
• Brandon D Blanton, CRNA
• Blue Ridge Medical Management (MSMG Vas Surg Nor)
• Blue Ridge Medical Management Corporation (First Assist / Urgent Care - Norton)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)
• Blue Ridge Medical Management Corporation (Ballad Health Medical Associates)

• Sports Medicine (Family Medicine) Physician in Norton, VA
• Providers in Norton, VA by specialty
• Sports Medicine (Family Medicine) Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2017; 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.