Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Abbye Nicole Blackwell, PA

Individual provider Physician Assistant · NPI 1902625098

Abbye Nicole Blackwell, PA is a Physician Assistant in Jackson, Mississippi. Qualified in 2024, 2 years ago. Practices with Mississippi Sports Medicine and Orthopaedic Center, a 73-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
2
Licensed in
MS
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1325 E Fortification St
Jackson, MS 39202-2442
Phone: (601) 354-4488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 00815 (MS)

Record details

NPI number1902625098
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedOctober 7, 2024
Last updated in NPPESOctober 7, 2024
Certification dateOctober 7, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Mississippi Sports Medicine And Orthopaedic Center — 73 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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