NPIMap

Organization Active NPI

Dr. George Blackwell Inc.

  • Chiropractor
  • Port St Lucie, FL
National Provider Identifier
1790300127
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR. GEORGE BLACKWELL INC.
Practice address
1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5536
Phone
(772) 335-3110
Fax
(772) 398-0704
NPI assigned
Jun 11, 2020
Last updated
Aug 26, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Authorized official

Name
Dr. George Blackwell III, DCNPI 1871055335
Title
President
Phone
(772) 335-3110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary
Physical Therapist 225100000X

Addresses

Primary practice location

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5536

Mailing address

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5536
Phone (772) 335-3110

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL Eclipse Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200701000750 FL Part B Supplier - Clinic/Group Practice 2769805225 Receives reassigned benefits from 7 practitioners
Practice locations: Port St Lucie, FL

National Provider Directory

National Provider Directory

Locations

1967 SE Port St Lucie Blvd
Port St Lucie, FL 34952
Phone (772) 335-3110

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787702400000",
    "number": "1790300127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1967 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525536",
            "telephone_number": "772-335-3110",
            "fax_number": "772-398-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1967 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525536",
            "telephone_number": "772-335-3110",
            "fax_number": "772-398-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. GEORGE BLACKWELL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-335-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Eclipse",
            "affiliation": "N",
            "endpointDescription": "EHR system",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1967 SE Port St Lucie Blvd",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349525536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.