NPIMap

Individual provider Active NPI

Blake Grayson Joeckel, MMS, PA-C

  • Physician Assistant
  • Fayetteville, NC
National Provider Identifier
1760946180
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08813 Issued in NC
Practice address
116 Country Club Dr
Fayetteville, NC 28301-7604
Phone
(910) 488-0157
NPI assigned
Jan 30, 2019
Last updated
May 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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 0010-08813 NC Primary
Family Medicine Physician 207Q00000X 0010-08813 NC

Addresses

Primary practice location

116 Country Club Dr
Fayetteville, NC 28301-7604

Mailing address

3677 Glenbarry Cir
Fayetteville, NC 28314-2605
Phone (910) 273-5150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190924001364 NC Practitioner - Physician Assistant 4082944723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4140 Ferncreek Dr
Suite 801
Fayetteville, NC 28314-2572
Phone (910) 484-2171

6000 Ramsey St
Suite 108
Fayetteville, NC 28311-7189
Phone (910) 484-3332

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
25.6 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
85.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Valley Health Medical Group LLC CurrentSince Nov 7, 2024 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Nov 7, 2024 Accepting new patients
Cape Fear Orthopaedic Clinic, P.a. CurrentSince Jul 19, 2021 Accepting new patients
Cape Fear Valley Health Medical Group LLC Past Accepting new patients

Locations

4140 Ferncreek Dr
Ste 801
Fayetteville, NC 28314
Phone (910) 484-2171

Interoperability endpoints

  • Direct secure messaging: bjoeckel93432@capefearvalley.direct-ci.com
  • Direct secure messaging: blake.joeckel.p1@direct.capefearortho.nextgenshare.com

Organizations & group practices 6

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1760946180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3677 GLENBARRY CIR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283142605",
            "telephone_number": "910-273-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 COUNTRY CLUB DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283017604",
            "telephone_number": "910-488-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOECKEL",
        "first_name": "BLAKE",
        "middle_name": "GRAYSON",
        "credential": "MMS, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08813",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0010-08813",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.