Samuel Dwight Blackwell, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

32989 Issued in NC

Practice address

1011 Pemberton Hill Rd
Suite 101
Apex, NC 27502-4266

Phone

(919) 367-9355

Fax

(919) 367-9276

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sblackwell21486@direct.medicine.duke.edu

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.

• Peak Family Medicine, PA

  • Nurse Practitioner
  • Apex, NC
  • NPI 1285734319

  Family Medicine

  NPD Authorized official
• Private Diagnostic Clinic, PLLC

  • General Practice Physician
  • Durham, NC
  • NPI 1457389033

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391385600000",
    "number": "1770677635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PEMBERTON HILL RD",
            "address_2": "SUITE 101",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024266",
            "telephone_number": "919-367-9355",
            "fax_number": "919-367-9276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 PEMBERTON HILL RD",
            "address_2": "SUITE 101",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275024266",
            "telephone_number": "919-367-9355",
            "fax_number": "919-367-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "SAMUEL",
        "middle_name": "DWIGHT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2014-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "32989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Cat Counseling & Wellness, PLLC
• Black Diamond Chiropractic and Sports Performance, PLLC
• Hannah Brown Black, OTR/L
• Joshua Blackburn
• Lynn Gantt Blackley, MA CCC SLP
• Stephanie Blair
• Ann Elizabeth Blankenship Clark, PA
• Amber Blanton, OTR/L
• Blissful Healing LLC
• Bloom Therapy Services, PLLC

• Family Medicine Physician in Apex, NC
• Providers in Apex, NC by specialty
• Family Medicine Physician in North Carolina

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