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FAIR BLUFF MEDICAL CLINIC PLLC
NPI 1699661652
Nurse Practitioner in Fair Bluff, NC

Active since June 16, 2025CLIA 34D2195837 · Waiver
12291 ANDREW JACKSON HWY SW, FAIR BLUFF, NC 28439(910) 207-2714 Get Directions Write a Review

NPPES record last updated: August 27, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fair Bluff Medical Clinic Pllc NPPES

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

FAIR BLUFF MEDICAL CLINIC PLLC (NPI 1699661652) is a healthcare organization registered as a nurse practitioner in Fair Bluff, North Carolina and active in the NPI registry since June 2025. The organization holds a CLIA Waiver certificate valid through August 7, 2027 and lists Elizabeth Paige Blackwell, Owner, as its authorized official.

NPPES Registry Identity

NPI1699661652
Entity TypeOrganization
Primary Taxonomy363L00000X
Legal Business NameFAIR BLUFF MEDICAL CLINIC PLLC
Location Address12291 ANDREW JACKSON HWY SWFair Bluff, NC 28439-9597
Mailing Address12291 Andrew Jackson Hwy SwFair Bluff, NC 28439-9597 · (910) 207-2714
Phone(910) 207-2714
Organization SubpartNo
Authorized OfficialElizabeth Paige BlackwellOwner · (910) 374-0722
Enumeration DateJune 16, 2025
Last NPPES UpdateAugust 27, 2025
NPPES CertifiedAugust 27, 2025
✔ NPI 1699661652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
12291 ANDREW JACKSON HWY SW, Fair Bluff, NC 28439
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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 SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2195837

Fair Bluff Medical Clinic, LLC · Fair Bluff, NC
Active · expires Aug 7, 2027
CLIA Number34D2195837
Laboratory TypeAcute Care/Primary
Certificate Effective DateAugust 8, 2025
Certificate Expiration DateAugust 7, 2027
Laboratory DirectorElizabeth Blackwell
Laboratory Phone(910) 217-2714
Laboratory LocationFair Bluff Medical Clinic, LLC12291 Andrew Jackson Hwy, Fair Bluff, NC 28439
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

ELIZABETH PAIGE BARNHILL-BLACKWELL FNP-C
Nurse Practitioner (Family)
12291 ANDREW JACKSON HWY SW
FAIR BLUFF, NC 28439
Columbus County (910) 374-0722

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 Fair Bluff Medical Clinic PLLC's NPI number?

The NPI number for Fair Bluff Medical Clinic PLLC is 1699661652. It was assigned to this organization in the NPPES registry on June 16, 2025.

Where is Fair Bluff Medical Clinic PLLC located?

Fair Bluff Medical Clinic PLLC is located at 12291 Andrew Jackson Hwy SW, Fair Bluff, NC 28439. The listed phone number is (910) 207-2714.

What is Fair Bluff Medical Clinic PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Does Fair Bluff Medical Clinic PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2195837) is associated with this NPI, valid through August 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fair Bluff Medical Clinic PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Fair Bluff Medical Clinic PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fair Bluff Medical Clinic PLLC was last updated on August 27, 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.