THOMAS L BLACKSTONE (NPI# 1912094301) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912094301 |
| Entity Type | Individual |
| Full Name | THOMAS L BLACKSTONE |
| Credential | MD |
| Practice Address |
3505 Converse Dr Ste 200 Wilmington NC 28403-6132 |
| Mailing Address |
Po Box 647 Hope Mills NC 28348-0647 |
| Practice Telephone | 9103925634 |
| Practice Fax Number | 9103925654 |
| Mailing Telephone | 9104837337 |
| Mailing Fax Number | 9104830648 |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2016-06-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 17469 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | MULTIPLAN | 12337276 | 01 |
| NC | COVENTRY OF THE CAROLINAS | 1542826 | 01 |
| NC | UNITED HEALTHCARE | 1409483 | 01 |
| NC | MEDCOST | 296275 | 01 |
| NC | HUMANA | 1912094301 | 01 |
| NC | 1912094301 | 05 | |
| NC | COVENTRY NATIONAL - COVENTRY PPO | 4550753 | 01 |
| NC | 8915986 | 05 | |
| NC | BCBS OF NC | 15986 | 01 |
| NC | DOCTORS DIRECT | 1912094301 | 01 |
| NC | AETNA | 4359214 | 01 |
| NC | FIRST CAROLINA CARE | FH1101875 | 01 |
| NC | HEALTHNET FEDERAL SERVICES | 1912094301 | 01 |
| NC | HEALTHSMART | 1912094301 | 01 |
| NC | WELLPATH | 1542826 | 01 |
| NC | CIGNA GREATWEST | 1791139 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326272659 | Thomas D Blackstone | Chiropractor | 1605 10th St, Gering, NE 69341-2409 | 2009-05-14 |
| Street Address |
3505 CONVERSE DR STE 200 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6132 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073532248 | Dimock Weinberg & Cherry Dds Pllc | Dentist | 3505 Converse Dr, Suite 175, Wilmington, NC 28403-6131 | 2006-07-19 |
| 1225524473 | Michelle Espinoza | Behavioral Analyst | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2018-07-10 |
| 1821519125 | Ashley Jill Koehler | Occupational Therapist | 3505 Converse Dr, Wilmington, NC 28403-6131 | 2017-06-28 |
| 1760865760 | Kidzcare Pediatrics, PC | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2015-07-08 |
| 1447638341 | Coastal Pediatric Associates, Pllc | Specialist | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2015-05-12 |
| 1891194015 | Raleigh Durham Medical Group, Pa | Pediatrics | 3505 Converse Dr, Ste 200, Wilmington, NC 28403-6131 | 2014-08-14 |
| 1821327768 | Shannon Dee Keely | Registered Nurse | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-12-23 |
| 1861628695 | Breony Miller Vinson | Physician Assistant | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-06-08 |
| 1588898571 | Whitney Nugent King | Pediatrics | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2009-05-06 |
| 1740342112 | Shawn Marie Desmond | Nurse Practitioner | 3505 Converse Dr, Suite 200, Wilmington, NC 28403-6131 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413875 | Ymca of Southeastern Nc | Health Educator | 2710 Market Street, Wilmington, NC 28403 | 2020-09-25 |
| 1659917334 | Noa Alper | Occupational Therapist | 5412 Old Garden Road, Wilmington, NC 28403 | 2019-11-18 |
| 1992346340 | Nancy Rosita Carson | Technician | 5608 Locke Str. Apt 108, Wilmington, NC 28403 | 2019-10-07 |
| 1912484585 | Jennifer Nicole Perry | Behavior Technician | 349 Campus Cv, Wilmington, NC 28403 | 2018-07-25 |
| 1386159929 | Monumental Foundations LLC | Clinic/Center | Plum Tree Plaza 925 South Kerr Ave Suite F4, Wilmington, NC 28403 | 2017-12-05 |
| 1114445731 | Jacqulyn Craichy | Speech-Language Pathologist | 75 Cavalier Drive, Wilmington, NC 28403 | 2017-09-04 |
| 1730638545 | Ashley Mcneil | Durable Medical Equipment & Medical Supplies | 3435 Wilshire Blvd Apt 203, Wilmington, NC 28403 | 2016-09-22 |
| 1306204276 | Valerie Pringle Jones | Physical Therapist | 1717 Shipyard Blvd. Ste 350, Wilmington, NC 28403 | 2016-02-05 |
| 1689039992 | Lifeline Treatment Center | Clinic/Center | 5710 Oleander Dr Ste 100, Wilmington, NC 28403 | 2015-12-31 |
| 1750758264 | Melissa Beatson | Speech-Language Pathologist | 4014 Oleander Drive, Ste. 3b, Coastal Speech & Language Pllc, Wilmington, NC 28403 | 2015-09-01 |
| Find all providers in zip 28403 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324307 | Manuel Roque Sanchez Gonzales Jr. | Pediatrics | Attn: Cindy Chuidian (gme Office), 1600 Rockland Rd, Wilmington, DE 19803 | 2020-04-06 |
| 1558908822 | Margaret Prygon | Pediatrics | 2620 Majestic Dr, Wilmington, DE 19810-2438 | 2019-12-05 |
| 1811309271 | Joanna Laura Shaffer | Pediatrics | 2055 Limestone Rd Ste 300, Wilmington, DE 19808 | 2014-05-20 |
| 1962841841 | Suguna Patibanda | Pediatrics | 2719 Pickering Rd, Wilmington, DE 19808-3636 | 2013-06-24 |
| 1952643314 | H. Leon Aussprung IIi | Pediatrics | 4619 Weldin Rd, Wilmington, DE 19803-4825 | 2013-03-25 |
| 1841556891 | Rachel A Overdevest | Pediatrics | 5500 Skyline Dr Ste 4, Wilmington, DE 19808-1772 | 2012-04-04 |
| 1770851925 | Forrest Glenn Hawkins | Pediatrics | 3 Perth Dr, Wilmington, DE 19803-2612 | 2011-12-02 |
| 1881987311 | Meghan Elizabeth Dougherty | Pediatrics | 2212 S 17th St, Wilmington, NC 28401-7515 | 2011-05-17 |
| 1467787184 | Annuradha Goel | Pediatrics | 1602 Jessup Street, Wilmington, DE 19802-4210 | 2009-10-14 |
| 1205078243 | Wilmington Health Pllc | Pediatrics | 4320 Henson Dr, Wilmington, NC 28405-7424 | 2009-04-06 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28403 |
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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.