Physician Assistant
JOHN BLAKE PA-C
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1780726570 · enumerated 2007-02-12 · record updated 2019-06-03. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Addresses and phones
- Practice location 712 VILLAGE RD SW STE 104, SHALLOTTE, NC, 28470-3449 (910) 754-7607 Fax (910) 754-7608 Google Maps Apple Maps OpenStreetMap
- Mailing address 712 VILLAGE RD SW STE 104, SHALLOTTE, NC, 28470-3449 (910) 754-7607 Fax (910) 754-7608 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant 363A00000X · Primary · License 103290NC NC
In this directory
Locations and evidence
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Practice location
SHALLOTTE, NC, 284703449
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.