Charles Samuel Blackadar, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

37686 Issued in WA

Practice address

1 Boone Rd
Naval Hospital
Bremerton, WA 98312-1894

Phone

(360) 475-4426

Fax

(360) 475-4344

NPI assigned

Oct 11, 2006

Sex

Male

Sole proprietor

Yes

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 AK

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 1

Specialty

Family Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alaska Medical Clinics LLCGroup PAC ID 3274617253, 9 clinicians

Alaska Urgent Care LLCGroup PAC ID 1355574484, 13 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• Alaska Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Anchorage, AK
  • NPI 1518389303

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Alaska Medical Clinics, LLC

  • Urgent Care Clinic/Center
  • Wasilla, AK
  • NPI 1316015480
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821187899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 LONDONDERRY LOOP NW",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121197",
            "telephone_number": "360-692-2276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOONE RD",
            "address_2": "NAVAL HOSPITAL",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121894",
            "telephone_number": "360-475-4426",
            "fax_number": "360-475-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKADAR",
        "first_name": "CHARLES",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "37686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jill Dianne Bishop
• Rebecca Bjorgen
• Hillary Bjorneboe
• Joshua Black
• Rachel Black
• Lauren Blacken, CO
• Griffith Blackmon, MD
• Christina Blair
• Otis Malcolm Blair, PHARMACIST
• Pauline R Blair

• Family Medicine Physician in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.