Dr Mott Parks Blair Iv, MD is a medicare enrolled "Family Medicine" physician in Wallace, North Carolina. He went to Brody School Of Medicine At East Carolina University and graduated in 1987 and has 37 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Vidant Medical Group Llc and his current practice location is
125 River Vine Pkwy, Wallace, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(910) 285-2134.
Dr Mott Parks Blair Iv is licensed to practice in North Carolina (license number 38496) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1447237623.
Physician's Profile
| Full Name | Dr Mott Parks Blair Iv |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 37 Years |
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| Location | 125 River Vine Pkwy, Wallace, North Carolina |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Mott Parks Blair Iv attended and graduated from Brody School Of Medicine At East Carolina University in 1987
NPI Data:
- NPI Number: 1447237623
- Provider Enumeration Date: 12/28/2005
- Last Update Date: 01/13/2022
Medicare PECOS Information:
- PECOS PAC ID: 5193807063
- Enrollment ID: I20090826000545
Medical Identifiers
Medical identifiers for Dr Mott Parks Blair Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1447237623 | NPI | - | NPPES |
| 16113 | Other | NC | BLUE CROSS BLUE SHEILD |
| 561711105 | Other | NC | TAX ID |
| 8916113 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 38496 (North Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Vidant Medical Group Llc | 0345343893 | 849 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mott Parks Blair Iv allows following entities to bill medicare on his behalf.
| Entity Name | Vidant Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477648731
PECOS PAC ID: 0345343893
Enrollment ID: O20070321000445 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mott Parks Blair Iv is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Mott Parks Blair Iv, MD
404 E Main St,
Wallace, NC 28466-2726
Ph: (910) 285-2134 | Dr Mott Parks Blair Iv, MD
125 River Vine Pkwy,
Wallace, NC 28466-2377
Ph: (910) 285-2134 |
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