Thomas Harold Blackwell, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

34991 Issued in SC

Practice address

300 Scuffletown Rd
Simpsonville, SC 29681-7204

Phone

(864) 329-0029

NPI assigned

Jul 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Greenville Health System

  dba GHS Patewood Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1568532513
  Medicare reassignment NPD
• Prisma Health-Upstate

  dba Prisma Health Greenville Memorial Hospital

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1649726738
  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine, NC

  Medicare reassignment NPD
• Greenville Health System

  dba GHS Patewood Op Center BLDG a

  • General Acute Care Hospital
  • Greenville, SC
  • NPI 1225453269
  NPD
• Prisma Health-Upstate

  dba Prisma Health Sleep Disorders Center-Verdae

  • Sleep Disorder Diagnostic Clinic/Center
  • Greenville, SC
  • NPI 1275086431
  NPD
• Prisma Health-Upstate

  dba Prisma Health Wonder Center-Non Medicaid

  • Medically Fragile Infants and Children Day Care
  • Greenville, SC
  • NPI 1811439649
  NPD

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1770508020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 SCUFFLETOWN RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296817204",
            "telephone_number": "864-329-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "THOMAS",
        "middle_name": "HAROLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "35587",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "NC",
            "license": "35587",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "34991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCBCBS",
            "identifier": "16021",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N35587",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8916021",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Delaney Black, PT
• Sonja Rena Black, RN
• Daniel Blackmon
• Connie J Blackstone, MD
• Marcus E Blackstone, MD
• Thomas Matthew Blackwell, DMD
• Lindsay Blair
• Christina L Blake, NP
• Haley Elise Blake, FNP-BC
• Amanda Blanton

• Emergency Medicine Physician in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Emergency Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.

Verify at the official NPI Registry.