| Christopher Blackwell, CNP | |
|
107 Ball Ave, Tylertown, MS 39667-2101 | |
| (601) 377-1975 | |
| (601) 377-1976 |
| Full Name | Christopher Blackwell |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 13 Years |
| Location | 107 Ball Ave, Tylertown, Mississippi |
| 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 |
|---|---|---|---|
| 1982964565 | NPI | - | NPPES |
| 103I507204 | Other | MS | MEDICARE PTAN |
| 01538051 | Medicaid | MS | |
| 9365915 | Other | MS | AETNA |
| 937501 | Other | MS | WINDSOR |
| P01087211 | Other | MS | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R871872 (Mississippi) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Encompass Health-home Health & Hospice | Hattiesburg, MS | Home health agency |
| St Luke Home Health Services | Mccomb, MS | Home health agency |
| Forrest General Home Care | Hattiesburg, MS | Home health agency |
| Walthall County General Hospital Cah | Tylertown, MS | Hospital |
| Field Health System | Centreville, MS | Hospital |
| Lawrence County Hospital Cah | Monticello, MS | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Blackwells Family Medicine Llc | 0749616381 | 4 |
| Southwest Mississippi Regional Medical Center | 5193633907 | 83 |
| Entity Name | Field Memorial Community Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881648376 PECOS PAC ID: 0547248544 Enrollment ID: O20040707001237 |
| Entity Name | Keystone Medical Services Of Ms Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174691059 PECOS PAC ID: 7618075177 Enrollment ID: O20070606000447 |
| Entity Name | Southwest Mississippi Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245289172 PECOS PAC ID: 5193633907 Enrollment ID: O20080512000089 |
| Entity Name | Southwest Mississippi Regional Medical Center |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1932211851 PECOS PAC ID: 5193633907 Enrollment ID: O20080512000285 |
| Entity Name | Walthall General Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245512417 PECOS PAC ID: 3678766094 Enrollment ID: O20111103000238 |
| Entity Name | Keystone Medical Services Of Gulfport Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881070183 PECOS PAC ID: 7113221011 Enrollment ID: O20160215000517 |
| Entity Name | Relias Emergency Medicine Specialists Of Mccomb, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477195972 PECOS PAC ID: 7517391121 Enrollment ID: O20200107000381 |
| Entity Name | Blackwells Family Medicine Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366003436 PECOS PAC ID: 0749616381 Enrollment ID: O20200130001390 |
| Entity Name | Rh Emergency Medicine Of Jefferson Davis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356103527 PECOS PAC ID: 4789023201 Enrollment ID: O20240417001265 |
| Entity Name | Rh Hospitalist Medicine Of Jefferson Davis Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174385355 PECOS PAC ID: 6103265145 Enrollment ID: O20240423003254 |
| Mailing Address | Practice Location Address |
|---|---|
| Christopher Blackwell, CNP 107 Ball Ave, Tylertown, MS 39667-2101 Ph: (601) 377-1975 | Christopher Blackwell, CNP 107 Ball Ave, Tylertown, MS 39667-2101 Ph: (601) 377-1975 |
Regina A Williams, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Hospital Dr, Tylertown, MS 39667 Phone: 601-876-5303 Fax: 601-876-0653 | |
Carol Hobgood, F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Hospital Dr, Tylertown, MS 39667 Phone: 601-876-5303 | |
Dr. Deondra Monique Carr, PHD, RN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 95 Need Yarborough Rd, Tylertown, MS 39667 Phone: 601-502-4187 | |
Chelsea Hill, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3000 Plaza Dr Ste C, Tylertown, MS 39667 Phone: 601-803-5676 Fax: 601-803-5677 | |
Mrs. Erin Broome Riley, MSN, APRN FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Hospital Dr, Tylertown, MS 39667 Phone: 601-876-5835 Fax: 601-876-5295 | |
Timothy Paul Martin, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Medical Cir, Tylertown, MS 39667 Phone: 731-394-1145 | |
Robin Elizabeth Campbell, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 107 Ball Ave, Tylertown, MS 39667 Phone: 601-377-1975 Fax: 601-377-1976 |