Active NPI
Patricia Ann Blackwell, MD
- Occupational Medicine Physician
- Norcross, GA
National Provider Identifier
1982896429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Medicine Physician
- License
- 030271
- Practice address
- 1905 Beaver Ruin Rd
Norcross, GA 30071-3837 - Phone
- (770) 441-0444
- NPI assigned
- Aug 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 030271 | GA | Primary |
Addresses
Primary practice location
1905 Beaver Ruin Rd
Norcross, GA 30071-3837
Mailing address
1905 Beaver Ruin Rd
Norcross, GA 30071-3837
Phone (770) 441-0444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291161600000",
"number": "1982896429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1905 BEAVER RUIN RD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300713837",
"telephone_number": "770-441-0444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1905 BEAVER RUIN RD",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300713837",
"telephone_number": "770-441-0444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-17",
"last_updated": "2010-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "GA",
"license": "030271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.