Active NPI
Elisabeth Grant Blackman, DDS
- General Practice Dentistry
- Concord, NC
National Provider Identifier
1811741002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13679
- Practice address
- 8528 Pit Stop CT NW Ste 30
Concord, NC 28027-8221 - Phone
- (704) 286-1794
- NPI assigned
- Apr 15, 2024
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13679 | NC | Primary |
Addresses
Primary practice location
8528 Pit Stop CT NW Ste 30
Concord, NC 28027-8221
Mailing address
2511 Cloister Dr
Charlotte, NC 28211-3915
Phone (704) 957-2161
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13679 | NC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752192000000",
"number": "1811741002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2511 CLOISTER DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282113915",
"telephone_number": "704-957-2161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8528 PIT STOP CT NW STE 30",
"city": "CONCORD",
"state": "NC",
"postal_code": "280278221",
"telephone_number": "704-286-1794"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKMAN",
"first_name": "ELISABETH",
"middle_name": "GRANT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-15",
"last_updated": "2025-07-11",
"certification_date": "2025-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "13679",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.