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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

BLACKHAWK MEDICAL, PLLC
NPI 1710807664
Nurse Practitioner - Adult Health in Canton, MS

Active since July 20, 2026
115 AULENBROCK DR # 100-B, CANTON, MS 39046(601) 624-1082 Get Directions Write a Review

NPPES record added: July 20, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Blackhawk Medical, Pllc NPPES

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

BLACKHAWK MEDICAL, PLLC (NPI 1710807664) is a healthcare organization registered as an adult health in Canton, Mississippi and active in the NPI registry since July 2026. The organization lists Virginia Lea Powell, Owner, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1710807664
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameBLACKHAWK MEDICAL, PLLC
Location Address115 AULENBROCK DR # 100-BCanton, MS 39046-7061
Mailing Address115 Aulenbrock Dr # 100-bCanton, MS 39046-7061 · (601) 624-1082
Phone(601) 624-1082
Organization SubpartNo
Authorized OfficialVirginia Lea PowellOwner, Nurse Practitioner · (601) 624-1082
Enumeration DateJuly 20, 2026
NPPES CertifiedJuly 20, 2026
✔ NPI 1710807664 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
Also ListedNurse PractitionerTaxonomy 363L00000X
Also ListedNurse Practitioner · GerontologyTaxonomy 363LG0600X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
115 AULENBROCK DR # 100-B, Canton, MS 39046
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 Blackhawk Medical, PLLC's NPI number?

The NPI number for Blackhawk Medical, PLLC is 1710807664. It was assigned to this organization in the NPPES registry on July 20, 2026.

Where is Blackhawk Medical, PLLC located?

Blackhawk Medical, PLLC is located at 115 Aulenbrock Dr # 100-B, Canton, MS 39046. The listed phone number is (601) 624-1082.

What is Blackhawk Medical, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Blackhawk Medical, PLLC was last updated on July 20, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.