1. Home
  2. Directory
  3. North Carolina
  4. Charlotte
  5. Family Medicine
  6. NPI Profile

DR. DERRICK LEWIS BLACKWELL DO
NPI 1134348485
Family Medicine in Charlotte, NC

Active since April 25, 2007PECOS EnrolledAccepts Medicare Assignment
4500 CAMERON VALLEY PKWY STE 100, CHARLOTTE, NC 28211(704) 384-7910(704) 384-7914 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 1, 2022, Oct 25, 2020 (2 updates tracked since 2020).

About Dr. Derrick Lewis Blackwell Do NPPES

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

DR. DERRICK LEWIS BLACKWELL DO (NPI 1134348485) is an individual family medicine provider in Charlotte, North Carolina, licensed in North Carolina (2014-00430) and active in the NPI registry since April 2007. He is enrolled in Medicare PECOS, is affiliated with Cleveland Clinic, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1134348485
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DERRICK LEWIS BLACKWELLCredential: DO
Location Address4500 CAMERON VALLEY PKWY STE 100Charlotte, NC 28211-3542
Mailing AddressPo Box 60447Charlotte, NC 28260-0447 · (704) 384-8640
Phone(704) 384-7910
Fax(704) 384-7914
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateApril 25, 2007
Last NPPES UpdateAugust 1, 20222 updates tracked since enumeration
NPPES CertifiedAugust 1, 2022
✔ NPI 1134348485 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in NC · 2014-00430✔ Licensed in MI · 5101016178
Definition
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.
4500 CAMERON VALLEY PKWY STE 100, Charlotte, NC 28211
Open in Google Maps ↗

Other Identifiers 1

Medicaid011221SC

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

Dr. Derrick Lewis Blackwell Do 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 ID9133218670
PECOS Enrollment IDI20251229002985
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.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
158 services66 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
68 services50 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
45 services25 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
35 services23 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
32 services23 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
28 services19 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28211 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
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
Percentage of patients aged 18 years and older with a diagnosis of COPD who had spirometry results documented
13%24 patients1/55-star benchmark: 100%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
91%141 patients4/55-star benchmark: 100%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
84%31 patients3/55-star benchmark: 100%
Elder Maltreatment Screen and Follow-Up Plan
Percentage of patients aged 65 years and older with a documented elder maltreatment screen using an Elder Maltreatment Screening Tool on the date of encounter AND a documented follow-up plan on the date of the positive screen
39%216 patients1/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
72%216 patients3/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
36%227 patients2/55-star benchmark: 100%
Screening for Osteoporosis for Women Aged 65-85 Years of Age
Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis
57%65 patients3/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
15 suppliers57 claims147 services$5.69 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
11 suppliers23 claims35 services$0.95 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
2 suppliers12 claims12 services$187.53 avg. paid by Medicare
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds K0823
DME-Wheelchairs · category DD009N
1 supplier12 claims12 services$120.02 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

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

ROSANNA DELVERME SILVA D.O.
Family Medicine
4500 CAMERON VALLEY PKWY STE 100
CHARLOTTE, NC 28211
Mecklenburg County (704) 384-7910
LILIAN QUSHAIR EVANS MD
Family Medicine
4500 CAMERON VALLEY PKWY STE 100
CHARLOTTE, NC 28211
Mecklenburg County (704) 384-7910

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 Derrick Blackwell's NPI number?

The NPI number for Derrick Blackwell is 1134348485. It was assigned to this individual provider in the NPPES registry on April 25, 2007.

Where is Derrick Blackwell located?

Derrick Blackwell practices at 4500 Cameron Valley Pkwy Ste 100, Charlotte, NC 28211. The listed phone number is (704) 384-7910.

What is Derrick Blackwell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Derrick Blackwell enrolled in Medicare?

Yes. Derrick Blackwell 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.

Is Derrick Blackwell affiliated with any hospitals?

According to CMS data, Derrick Blackwell is affiliated with Cleveland Clinic.

When was this NPI record last updated?

The NPPES record for Derrick Blackwell was last updated on August 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.