Roy C Blank, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

30777 Issued in NC

Practice address

1995 Wellness Blvd
Suite 110, BLDG B
Monroe, NC 28110-7769

Phone

(704) 384-1140

Fax

(704) 384-1141

NPI assigned

Apr 5, 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: rblank14698@direct.novanthealth.org

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1912969817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-7840",
            "fax_number": "704-384-7830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 WELLNESS BLVD",
            "address_2": "SUITE 110, BLDG B",
            "city": "MONROE",
            "state": "NC",
            "postal_code": "281107769",
            "telephone_number": "704-384-1140",
            "fax_number": "704-384-1141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANK",
        "first_name": "ROY",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "30777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N30777",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8916227",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis Poindexter Blackburn, MSW, LCSWA
• Joy Blackwelder
• Blake & Blythe, LLC
• Leeann McCamy Blake, WHNP-BC
• Eusheakia Blakeney
• Tommy Michael Blankenship, CRNA
• Tamara Lavette Blount
• Allison C Boissey, OTR/L
• Alexis Victoria Bonsall, LPCA, NCC
• Cara Bonwell-Orr, LCSW

• Internal Medicine Physician in Monroe, NC
• Providers in Monroe, NC by specialty
• Internal Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.