MICHELLE RAE BLAIR NP-C NPI 1104489111

NPI Information

NPI: 1104489111
Provider Name: MICHELLE RAE BLAIR, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

Organization: SPARTANBURG MEDICAL CENTER

PECOS Registration: Yes

Address:
1200 E MAIN ST STE 12
SPARTANBURG, SC
ZIP 29307
Phone: (864) 560-9260
Get Directions

Michelle Rae Blair, NP-C is a family nurse practitioner in Spartanburg, SC with 5 years of experience. Michelle Rae Blair, NP-C NPI is 1104489111. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1200 E MAIN ST STE 12
SPARTANBURG, SC
ZIP 29307-738
Phone: (864) 560-9260
Fax: (864) 560-9265

The NPI 1104489111 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/16/2019 and was last updated on 11/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	0024177529	VIRGINIA	No
2	363LF0000X	Nurse Practitioner	Family	24897	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	SCK1055019	OTHER	SOUTH CAROLINA	MEDICARE PIN
2	SCK1056084	OTHER	SOUTH CAROLINA	MEDICARE PIN
3	NP7525	MEDICAID	SOUTH CAROLINA
4	SCK105J577	OTHER	SOUTH CAROLINA	MEDICARE PIN
5	SCK1056067	OTHER	SOUTH CAROLINA	MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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