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BLAKE FAMILY MEDICINE PLLC
NPI 1295959310
Family Medicine in Shallotte, NC

Active since April 12, 2007
4704 MAIN ST, SHALLOTTE, NC 28470(910) 754-4545(910) 754-4794 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

About Blake Family Medicine Pllc NPPES

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

BLAKE FAMILY MEDICINE PLLC (NPI 1295959310) is a healthcare organization registered as a family medicine in Shallotte, North Carolina and active in the NPI registry since April 2007. The organization lists John A Blake, Owner, as its authorized official.

NPPES Registry Identity

NPI1295959310
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBLAKE FAMILY MEDICINE PLLC
Location Address4704 MAIN STShallotte, NC 28470-1880
Mailing AddressPo Box 3206Shallotte, NC 28459-3206 · (910) 754-4545 · Fax (910) 754-4794
Phone(910) 754-4545
Fax(910) 754-4794
Organization SubpartNo
Authorized OfficialJohn A BlakeOwner · (910) 754-4545
Enumeration DateApril 12, 2007
Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration
✔ NPI 1295959310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NC · 10868
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.
Also ListedPhysician AssistantTaxonomy 363A00000X · License 103290 (NC), 103296 (NC)
4704 MAIN ST, Shallotte, NC 28470
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Other Identifiers 5

Medicaid5902868NC
Other017W4NC · Bcbs Grp
Other55210NC · Bcbs
Other185616NC · Medcost
Other858799NC · Uhc

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

SIENA LEONE
Dentist (General Practice)
4704 MAIN ST
SHALLOTTE, NC 28470
Brunswick County (910) 755-7645
DR. CAMMIE THOMPSON MORRIS DDS
Dentist
4704 MAIN ST
SHALLOTTE, NC 28470
Brunswick County (910) 755-7645
MORRIS AND CARMICHAEL 1 DDS PLLC
Dentist (General Practice)
4704 MAIN ST
SHALLOTTE, NC 28470
Brunswick County (910) 455-7645
CAMMIE T MORRIS DDS PA
Dentist (General Practice)
4704 MAIN ST
SHALLOTTE, NC 28470
Brunswick County (910) 755-7645

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 Blake Family Medicine PLLC's NPI number?

The NPI number for Blake Family Medicine PLLC is 1295959310. It was assigned to this organization in the NPPES registry on April 12, 2007.

Where is Blake Family Medicine PLLC located?

Blake Family Medicine PLLC is located at 4704 Main St, Shallotte, NC 28470. The listed phone number is (910) 754-4545.

What is Blake Family Medicine PLLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Blake Family Medicine PLLC was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.