Active NPI
Kimberly L Blackwell, MD
- Hematology & Oncology Physician
- Durham, NC
National Provider Identifier
1720161946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- License
- 95-01495
- Practice address
- Duke South I Trent Dr
Campus Box 3893
Durham, NC 27710-0001 - Phone
- (919) 668-1748
- Fax
- (919) 681-0874
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | 95-01495 | NC | Primary |
Addresses
Primary practice location
Duke South I Trent Dr
Campus Box 3893
Durham, NC 27710-0001
Mailing address
Duke South I Trent Dr
Campus Box 3893
Durham, NC 27710-0001
Phone (919) 668-1748
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89126TH | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95-01495 | NC | MD | Hematology & Oncology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720161946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DUKE SOUTH I TRENT DR",
"address_2": "CAMPUS BOX 3893",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-668-1748",
"fax_number": "919-681-0874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "DUKE SOUTH I TRENT DR",
"address_2": "CAMPUS BOX 3893",
"city": "DURHAM",
"state": "NC",
"postal_code": "277100001",
"telephone_number": "919-668-1748",
"fax_number": "919-681-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "KIMBERLY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "NC",
"license": "95-01495",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89126TH",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.