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SIARA SOUTHERLAND BLACKBURN
NPI 1063228468
Physician Assistant in Wilmington, NC

Active since December 10, 2024PECOS EnrolledAccepts Medicare Assignment
3787 SHIPYARD BLVD, WILMINGTON, NC 28403(910) 332-3800(910) 251-0421 Get Directions Write a Review

NPPES record last updated: January 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 18, 2026, Dec 10, 2024 (2 updates tracked since 2024).

About Siara Southerland Blackburn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SIARA SOUTHERLAND BLACKBURN (NPI 1063228468) is an individual physician assistant in Wilmington, North Carolina, licensed in North Carolina (0010-15739) and active in the NPI registry since December 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in Buies Creek, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1063228468
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSIARA SOUTHERLAND BLACKBURN
Location Address3787 SHIPYARD BLVDWilmington, NC 28403-6148
Mailing AddressPo Box 5105Belfast, ME 04915-5100 · (910) 332-3800 · Fax (910) 251-0421
Phone(910) 332-3800
Fax(910) 251-0421
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateDecember 10, 2024
Last NPPES UpdateJanuary 18, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2026
✔ NPI 1063228468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-15739
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3787 SHIPYARD BLVD, Wilmington, NC 28403
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Other Names 1

Former Name (1)Siara Nicole Southerland

Secondary Practice Location 1

Location 1PO Box 563Buies Creek, NC 27506-0563 · Phone (910) 742-7823

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Siara Southerland Blackburn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8123508124
PECOS Enrollment IDI20260218001333
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRAD WINSLOW NOLAN DPT
Physical Therapist
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 332-3800
TAMARA FAYE HAYES PA-C
Physician Assistant
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 332-3800
DR. NEIL ROSS MACINTYRE III M.D.
Orthopaedic Surgery
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 763-2361
EMERGEORTHO, PA
Orthopaedic Surgery
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 332-3800
FELIPE EDWIN SANCHEZ PT
Physical Therapist
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 332-3800
KAYLA MARIE NORRIS PA-C
Physician Assistant
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 386-8161
MS. ERICA BRADSHAW PTA
Physical Therapy Assistant
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 763-2361
TRENTON THOMAS STEVENS M.D.
Orthopaedic Surgery
3787 SHIPYARD BLVD
WILMINGTON, NC 28403
New Hanover County (910) 909-4163

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Siara Blackburn's NPI number?

The NPI number for Siara Blackburn is 1063228468. It was assigned to this individual provider in the NPPES registry on December 10, 2024. The provider is also known as Siara Nicole Southerland.

Where is Siara Blackburn located?

Siara Blackburn practices at 3787 Shipyard Blvd, Wilmington, NC 28403. The listed phone number is (910) 332-3800.

What is Siara Blackburn's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Siara Blackburn enrolled in Medicare?

Yes. Siara Blackburn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Siara Blackburn was last updated on January 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.