Sally L Blackburn (NPI# 1700857216, PAC ID# 8022153642) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
Nation Provider ID (NPI) | 1700857216 |
PAC ID by PECOS | 8022153642 |
Professional Enrollment ID | I20100308000506 |
Full Name | Sally L Blackburn |
Organization Legal Name | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC |
Address |
13168 Meadowview Sq Meadowview VA 24361-3328 |
Phone Number | 2769443999 |
Gender | F |
Graduation Year | 2001 |
Primary Specialty | NURSE PRACTITIONER |
Group Practice PAC ID | 4880502707 |
Number of Group Practice Members | 20 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
440012 | WELLMONT BRISTOL REGIONAL MEDICAL CENTER |
490053 | JOHNSTON MEMORIAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
2195 Euclid Ave, Bristol, VA 24201-3655 | 2766695179 | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC |
13168 Meadowview Sq, Meadowview, VA 24361-3328 | 2769443999 | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC |
308 W Main St, Saltville, VA 24370-3112 | 2764964433 | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC |
Organization Legal Name | SOUTHWEST VIRGINIA COMMUNITY HEALTH SYSTEMS INC |
Physicians | 22 |
Name | Specialty | Organization | Address |
---|---|---|---|
Katie C Olubowale | Family Medicine | Southwest Virginia Community Health Systems Inc | 2195 Euclid Ave, Bristol, VA 24201-3655 |
Tara R Prater | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 386 Ben Bolt Ave, Tazewell, VA 24651-5386 |
Kristin O Bresowar | Family Medicine | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Pamela M Somervell | Family Medicine | Southwest Virginia Community Health Systems Inc | 308 W Main St, Saltville, VA 24370-3112 |
Marcy S Rosenbaum | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 319 5th Ave, Fl 1, Saltville, VA 24370-3418 |
Vicente Ortiz | General Practice | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Katie Newsome-deel | Nurse Practitioner | Southwest Virginia Community Health Systems Inc | 308 W Main St, Saltville, VA 24370-3112 |
Stephanie R Branham | Nurse Practitioner | Southwest Virginia Community Health Systems Inc | 308 W Main St, Saltville, VA 24370-3112 |
Melissa Doane-williams | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Carol Ann R Wilson | Nurse Practitioner | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Street Address |
13168 MEADOWVIEW SQ |
City | MEADOWVIEW |
State | VA |
Zip | 24361-3328 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kristin O Bresowar | Family Medicine | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Vicente Ortiz | General Practice | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Melissa Doane-williams | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Carol Ann R Wilson | Nurse Practitioner | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Tracy Lyn Meek | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Lorelle Destefano | Clinical Social Worker | Southwest Virginia Community Health Systems Inc | 13168 Meadowview Sq, Meadowview, VA 24361-3328 |
Name | Specialty | Organization | Address |
---|---|---|---|
Karen A Elmore | Internal Medicine | Abingdon Physician Partners | 12180 Alder St, Meadowview, VA 24361-3938 |
City | MEADOWVIEW |
Zip Code | 24361 |
Specialty | NURSE PRACTITIONER |
City + Specialty | MEADOWVIEW + NURSE PRACTITIONER |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.