| Dr Shem Kearney Blackley Iii, MD | |
|
1001 N Washington St, Shelby, NC 28150-1800 | |
| (704) 482-2011 | |
| (704) 484-0303 |
| Full Name | Dr Shem Kearney Blackley Iii |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Experience | 42 Years |
| Location | 1001 N Washington St, Shelby, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578576674 | NPI | - | NPPES |
| 340013360 | Other | NC | RR MEDICARE |
| 32340 | Other | NC | NC MEDICAL LICENSE # |
| 230126 | Other | NC | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 32340 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Atrium Health Cleveland | Shelby, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Stone Institute Of The Carolinas Llc | 3173412533 | 34 |
| Carolina Urology Partners Pllc | 8921280587 | 37 |
| Entity Name | Stone Institute Of The Carolinas Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457377954 PECOS PAC ID: 3173412533 Enrollment ID: O20040312001126 |
| Entity Name | Carolina Urology Partners Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013210004 PECOS PAC ID: 8921280587 Enrollment ID: O20110303000580 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shem Kearney Blackley Iii, MD 9735 Kincey Ave, Suite 201, Huntersville, NC 28078-9118 Ph: (704) 414-2870 | Dr Shem Kearney Blackley Iii, MD 1001 N Washington St, Shelby, NC 28150-1800 Ph: (704) 482-2011 |
Dr. Johnson H Kelly, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 201 E Grover St, Shelby, NC 28150 Phone: 980-487-4721 Fax: 980-487-3942 | |
Dr. David B Barker, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 951 Wendover Heights Dr, Shelby, NC 28150 Phone: 704-487-4677 Fax: 704-481-8050 | |
Dr. Michael Eugene Brame, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 1001 N Washington St, Shelby, NC 28150 Phone: 704-482-2011 Fax: 704-484-0303 | |
Dr. Robert Peter Gossett, M.D. Urology Medicare: Medicare Enrolled Practice Location: 1001 N Washington St, Shelby, NC 28150 Phone: 704-482-2011 Fax: 704-484-0303 |