George Howard Blackwell III, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH12778 Issued in FL

Practice address

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

Phone

(772) 335-3110

Fax

(772) 398-0704

NPI assigned

Apr 3, 2019

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 FL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr. George Blackwell Inc.Group PAC ID 2769805225, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dr. George Blackwell Inc.

  • Chiropractor
  • Port St Lucie, FL
  • NPI 1790300127
  Medicare reassignment Care Compare group NPD Authorized official
• Pga Chiropractic Health Center PA

  • Chiropractor
  • Palm Beach Gardens, FL
  • NPI 1962799213
  Medicare reassignment NPD

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654905600000",
    "number": "1871055335",
    "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": {
        "last_name": "BLACKWELL",
        "first_name": "GEORGE",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-06-11",
        "certification_date": "2022-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH12778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birdgeway Group LLC
• Graziella Bitzer
• Kimberlee Bjorn, LMT
• Kristen Bjorn
• Gary M Blackmon, R.PH.
• Hannah Blair, COTA
• Margaret Giles Blair
• Kiana L Blake, RBT
• Mickia Ticre Blake
• Naomi Blake, LMHC

• Chiropractor in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.