Blake A Spain, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

9800704 Issued in NC

Practice address

920 Church St N
Concord, NC 28025-2927

Phone

(704) 403-1331

Fax

(704) 403-2533

NPI assigned

Aug 19, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Internal MedicineAlso: Critical Care (Intensivists), Pulmonary Disease

Education

Indiana University School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Brandon Hospital Hospital, Brandon, FL, CCN 100243
• HCA Florida South Shore Hospital Hospital, Sun City Center, FL, CCN 100259

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  Critical Care Medicine

  Medicare reassignment Care Compare group NPD
• Intensivist Medicine Services of FL, LLC

  • Critical Care Medicine (Internal Medicine) Physician
  • Tampa, FL
  • NPI 1235836388
  Medicare reassignment NPD
• Concord Women'S Specialty Care, Inc.

  • Obstetrics & Gynecology Physician
  • Concord, NC
  • NPI 1144486333
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Galencare, Inc.

  • General Acute Care Hospital
  • Brandon, FL
  • NPI 1669427258
  Care Compare affiliation
• Sun City Hospital Inc

  • General Acute Care Hospital
  • Sun City Center, FL
  • NPI 1164476867
  Care Compare affiliation

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1952416331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1331",
            "fax_number": "704-403-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 CHURCH ST N",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252927",
            "telephone_number": "704-403-1331",
            "fax_number": "704-403-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAIN",
        "first_name": "BLAKE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "NC",
            "license": "9800704",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NC",
            "license": "9800704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ALL PLANS",
            "identifier": "1053H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "9840261",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791053H",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1281816",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "200322",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BLAKE.SPAIN@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "920 Church St N",
            "city": "Concord",
            "state": "NC",
            "country_code": "US",
            "postal_code": "280252927",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Southeastern Recovery Center
• Dustin M Souther, CRNA
• Southern Assisted Living, LLC.
• Southern Piedmont Community Care Plan, Inc.
• Nathan Sowle
• Scott Spainhour
• Melissa Diane Sparks, LAT, ATC
• Victoria Anne Sparrow
• Victoria Spaziani, MS, OTR/L
• Faith Speaks, PH.D.

• Pulmonary Disease Physician in Concord, NC
• Providers in Concord, NC by specialty
• Pulmonary Disease Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2022; 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.