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KIMBERLY NICOLE BLACKWELL PA-C
NPI 1487439089
Physician Assistant in Wilmington, NC

Active since August 30, 2023PECOS EnrolledAccepts Medicare Assignment
613 SHIPYARD BLVD STE 106, WILMINGTON, NC 28412(910) 202-3068 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kimberly Nicole Blackwell Pa-c NPPES

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

KIMBERLY NICOLE BLACKWELL PA-C (NPI 1487439089) is an individual physician assistant in Wilmington, North Carolina, licensed in North Carolina (0010-15641) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1487439089
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKIMBERLY NICOLE BLACKWELLCredential: PA-C
Location Address613 SHIPYARD BLVD STE 106Wilmington, NC 28412-6491
Mailing Address615 Shipyard Blvd Ste 106Wilmington, NC 28412-6431 · (910) 202-3860
Phone(910) 202-3068
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateAugust 30, 2023
Last NPPES UpdateOctober 21, 2025
NPPES CertifiedOctober 21, 2025
✔ NPI 1487439089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in NC · 0010-15641
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.
613 SHIPYARD BLVD STE 106, Wilmington, NC 28412
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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

Kimberly Nicole Blackwell Pa-c 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 ID7214417724
PECOS Enrollment IDI20260213003903
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 28412 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

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

MISS KATHARINE ELIZABETH HANAVAN LCSW
Social Worker (Clinical)
613 SHIPYARD BLVD STE 106
WILMINGTON, NC 28412
New Hanover County (910) 202-3860

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 Kimberly Blackwell's NPI number?

The NPI number for Kimberly Blackwell is 1487439089. It was assigned to this individual provider in the NPPES registry on August 30, 2023.

Where is Kimberly Blackwell located?

Kimberly Blackwell practices at 613 Shipyard Blvd Ste 106, Wilmington, NC 28412. The listed phone number is (910) 202-3068.

What is Kimberly Blackwell's specialty?

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

Is Kimberly Blackwell enrolled in Medicare?

Yes. Kimberly 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.

When was this NPI record last updated?

The NPPES record for Kimberly Blackwell was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.