David Justin Blalock, ARNP
Individual provider Active NPI Family Nurse Practitioner · Wauchula, FL
NPI 1922076124 · NPPES record last updated Aug 26, 2013
Key facts
- NPI
- 1922076124
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ARNP2833192 (FL)
- Practice address
- 515 Carlton St
Wauchula, FL 33873-3407 - Phone
- (863) 773-6606
- NPI assigned
- Mar 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Adventist Health System-Sunbelt Inc
Practice addresses (Care Compare)
515 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-6606
533 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-3101
Hospital & facility affiliations
- Adventhealth Home Health
- Adventhealth Wauchula
- Adventhealth Sebring
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20031218000915 | FL | Practitioner - Nurse Practitioner | 6608773536 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adventist Health System-Sunbelt Inc | Current |
Accepting new patients | |
| Adventist Health System-Sunbelt Inc | Family | Current |
Accepting new patients |
| Adventist Health System-Sunbelt Inc | Current | Accepting new patients | |
| Adventist Health System-Sunbelt Inc | Current |
Accepting new patients | |
| Paragon Emergency Services LLC | Current |
Accepting new patients | |
| Emergency Medicine of Florida, Inc. | Past | Accepting new patients |
Locations
206 2nd St E
Bradenton, FL 34208
Phone (941) 745-7202
3625 University Blvd S
Jacksonville, FL 32216
Phone (904) 333-9404
1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777
4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406
4101 Sun N Lake Blvd
Sebring, FL 33872
515 Carlton St
Wauchula, FL 33873
Phone (863) 773-6606
735 S 5th Ave
Wauchula, FL 33873
Phone (863) 402-3402
522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975
Interoperability endpoints
- dblalock617835@adventhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP2833192 | FL | Yes |
Addresses
Primary practice location
515 Carlton St
Wauchula, FL 33873-3407
Mailing address
515 Carlton St
Wauchula, FL 33873-3407
Phone (863) 773-6606
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 306580400 | Medicaid | FL |
Other providers in Wauchula, FL
- Crystal Richards Bass
- Robert Batsevich
- Wendy Battles
- Shannon Gormel Beattie
- Bio-Medical Applications of Florida, Inc.
- Rebecca Block
- Magali Bobe
- Cheryl Bone
- Rebecca L Bowden
- Ajit K. Brar
All providers in Wauchula, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.