BLAKE HARRISON MOORE (NPI# 1306855143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306855143 |
| Entity Type | Individual |
| Full Name | BLAKE HARRISON MOORE |
| Credential | MD FACS |
| Practice Address |
506 Highway 301 N Dillon SC 29536-2958 |
| Mailing Address |
308 Dolphin Dr Jacksonville NC 28546-5266 |
| Practice Telephone | 8436273516 |
| Practice Fax Number | 8436273663 |
| Mailing Telephone | 9103462273 |
| Mailing Fax Number | 9103461907 |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2014-02-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 21490 | SC | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 21490 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | T56301 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992903769 | Blake Walter Moore | Urology | 9101 Stony Point Dr., Richmond, VA 23235 | 2007-07-03 |
| 1801883756 | Blake Edwin Moore | Dentist | 2190 E Bidwell St, Folsom, CA 95630-6453 | 2005-10-05 |
| 1699387571 | Blake Moore | Pharmacist | 1155 E Saint Louis St, Springfield, MO 65806-2527 | 2020-08-20 |
| 1972896181 | Blake A Moore | Anesthesiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2011-05-20 |
| 1326215518 | Blake E Moore | Orthopaedic Surgery | 1800 Camelot Dr, Suite 300, Virginia Beach, VA 23454-2440 | 2008-05-15 |
| Street Address |
506 HIGHWAY 301 N |
| City | DILLON |
| State | SC |
| Zip Code | 29536-2958 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578824546 | Med First Immediate Care & Family Practice, Pa | Clinic/Center | 506 Highway 301 N, Dillon, SC 29536-2958 | 2012-06-06 |
| 1104345693 | Med First Immediate Care & Family Practice, Pa | Family Medicine | 506 Highway 301 N, Dillon, SC 29536-2958 | 2017-09-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648858 | Melanie Daniels Smith | Registered Nurse | 1803 Joan Drive, Dillon, SC 29536 | 2020-10-26 |
| 1740888197 | Ashlyn Syvanna Arnette | Registered Nurse | 1001 West Calhoun Street, Dillon, SC 29536 | 2020-10-16 |
| 1245846179 | Chasity Nichole Chavis | Registered Nurse | 2159 Hwy 9 West, Dillon, SC 29536 | 2020-09-16 |
| 1376047811 | Medysis Healthcare | Home Health | 1000 N. Us 301, Dillon, SC 29536 | 2018-03-20 |
| 1548768278 | Medysis Healthcare | Home Health | 1000 N. Us-301, Dillon, SC 29536 | 2018-01-29 |
| 1639547565 | Tynia S Thomas | Counselor | 1324 Commerce, Dillon, SC 29536 | 2015-09-09 |
| 1528457967 | David Brown | Pharmacist | 804 Enterprise Rd, Dillon, SC 29536 | 2015-01-22 |
| 1891103701 | Fairlynn Grooms | Pharmacist | 611 U.S. 301 Highway, Dillon, SC 29536 | 2014-07-24 |
| 1790035483 | Lindsay Elizabeth Hyduke | Pharmacist | 1211 Hwy 301 North, Dillon, SC 29536 | 2012-09-11 |
| 1386932838 | Nardin Nabil Khalil | Family Medicine | 603 North 6th Avenue, Dillon, SC 29536 | 2011-07-19 |
| Find all providers in zip 29536 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386932838 | Nardin Nabil Khalil | Family Medicine | 603 North 6th Avenue, Dillon, SC 29536 | 2011-07-19 |
| 1487754230 | John S Madany | Family Medicine | 30 Hwy 91 S, Suite 100, Dillon, MT 59725-3513 | 2006-09-22 |
| 1235181504 | Bruce T Hayward | Family Medicine | 600 Mt Highway 91 S, Dillon, MT 59725-7379 | 2006-05-16 |
| 1629057401 | Dillon Family Medicine, P.a. | Family Medicine | 603 N 6th Ave, Dillon, SC 29536-2503 | 2006-01-11 |
| 1750380416 | Lesa K Bethea | Family Medicine | 509 E Roosevelt St, Dillon, SC 29536-2943 | 2005-07-15 |
| 1942206099 | James Oberheide | Family Medicine | 103 Main Street, Dillon, CO 80435 | 2005-06-23 |
| 1104345693 | Med First Immediate Care & Family Practice, Pa | Family Medicine | 506 Highway 301 N, Dillon, SC 29536-2958 | 2017-09-15 |
| 1255608113 | Physicians Healthcare of Dillon | Family Medicine | 1639 Highway 301 N, Dillon, SC 29536-1945 | 2011-11-21 |
| 1447546601 | Hallie Ann Kerins Tipton | Family Medicine | 30 Mt Highway 91 S, Dillon, MT 59725-3535 | 2011-06-24 |
| 1912137092 | Kelly Havig Smith | Family Medicine | 600 Hwy 91 South, Dillon, MT 59725-7379 | 2009-07-22 |
| Find all providers in DILLON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.