Maribelle M Blackmon, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024172045 Issued in VA

Practice address

1226 Progressive Dr Ste 101
Chesapeake, VA 23320-2847

Phone

(757) 609-3301

NPI assigned

Sep 17, 2014

Last updated

Feb 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenbrier Health and Wellness Center LLC

  dba Greenbrier Health and Wellness

  • Family Nurse Practitioner
  • Chesapeake, VA
  • NPI 1548819014
  Medicare reassignment Authorized official
• Velocity Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Williamsburg, VA
  • NPI 1205350584
  Medicare reassignment NPD

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1972905305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1226 PROGRESSIVE DR STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202847",
            "telephone_number": "757-609-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1226 PROGRESSIVE DR STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202847",
            "telephone_number": "757-609-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKMON",
        "first_name": "MARIBELLE",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-17",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024172045",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024172045",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.greenbrierwellness.com",
            "affiliation": "N",
            "address_1": "1226 Progressive Dr Ste 101",
            "city": "Chesapeake",
            "state": "VA",
            "country_code": "US",
            "postal_code": "233202847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• BJ's Wholesale Club Inc.
• BJS Wholesale Club Inc (BJS Pharmacy)
• Black Top Town Car Service LLC
• Jennifer Black, LCSW
• Sharon M. Black
• Sara Qualls Blaha, LDN, RD
• Heather Lynn Blakley, MS, CCC-SLP
• Tracy Baker Blalock, PHARMD
• Peyton Reisch Blankenship, DPT
• Shelly Bleil, LCSW

• Family Nurse Practitioner in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2020; 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.