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MR. PHILLIP WAYNE BLAICH PA-C
NPI 1861458424
Physician Assistant - Medical in Maxwell Afb, AL

Active since April 24, 2006PECOS Enrolled
300 TWINING ST BLDG 760, MAXWELL AFB, AL 36112(334) 953-8607(850) 747-2222 Get Directions Write a Review

NPPES record last updated: December 10, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 10, 2021, Jul 16, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2018).

About Mr. Phillip Wayne Blaich Pa-c NPPES

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

MR. PHILLIP WAYNE BLAICH PA-C (NPI 1861458424) is an individual medical provider in Maxwell Afb, Alabama, licensed in Florida (PA9103668) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1861458424
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. PHILLIP WAYNE BLAICHCredential: PA-C
Location Address300 TWINING ST BLDG 760Maxwell Afb, AL 36112-6027
Mailing Address300 Twining St Bldg 760Maxwell Afb, AL 36112-6027 · (334) 953-8607 · Fax (850) 747-2222
Phone(334) 953-8607
Fax(850) 747-2222
Sole ProprietorNo
Enumeration DateApril 24, 2006
Last NPPES UpdateDecember 10, 20214 updates tracked since enumeration
NPPES CertifiedDecember 10, 2021
✔ NPI 1861458424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in FL · PA9103668✔ Licensed in IL · 085003348
300 TWINING ST BLDG 760, Maxwell Afb, AL 36112
Open in Google Maps ↗

Other Identifiers 1

Medicaid020471300FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Phillip Wayne Blaich Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 20

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

DEAN EDWARD SCHULTZ III O.D.
Optometrist
300 TWINING ST BLDG 760
MONTGOMERY, AL 36112
Montgomery County (334) 953-3368
DR. REBECCA KATHERINE BRINCKS DDS
Dentist (General Practice)
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (334) 953-7822
DR. AMANDA SIMMONS DUTY O.D.
Optometrist
300 TWINING ST BLDG 760
MONTGOMERY, AL 36112
Montgomery County (335) 953-9748
DR. MELISSA NASH EVERAGE NURSE PRACTITIONER
Nurse Practitioner (Women's Health)
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (334) 953-5200
MALIA SILVA THOMAS CRNP, FNP
Nurse Practitioner (Family)
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (334) 953-5200
DR. PAUL A TILTON M.D.
Family Medicine
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (334) 953-5200
DR. CLAYTON J RABENS M.D., M.P.H.
Family Medicine
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (334) 953-5200
HALEY SUZANNE LORD PA-C
Physician Assistant
300 TWINING ST BLDG 760
MAXWELL AFB, AL 36112
Montgomery County (209) 747-2489

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 Phillip Blaich's NPI number?

The NPI number for Phillip Blaich is 1861458424. It was assigned to this individual provider in the NPPES registry on April 24, 2006.

Where is Phillip Blaich located?

Phillip Blaich practices at 300 Twining St Bldg 760, Maxwell Afb, AL 36112. The listed phone number is (334) 953-8607.

What is Phillip Blaich's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Phillip Blaich enrolled in Medicare?

Yes. Phillip Blaich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Phillip Blaich was last updated on December 10, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.