Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Nicole Blackwell, PA-C

Individual provider Physician Assistant · NPI 1487439089

Kimberly Nicole Blackwell, PA-C is a Physician Assistant in Wilmington, North Carolina. Qualified in 2024, 2 years ago. Practices with Coastal Horizons Center, Inc, a 50-clinician group, works from 6 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
2
Licensed in
NC
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

613 Shipyard Blvd Ste 106
Wilmington, NC 28412-6491
Phone: (910) 202-3068
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (5)

  • 7910 Us Hwy 117 S, Rocky Point, NC 28457-9431 — (910) 259-0668
  • 7910 Us Hwy 117 S # A, Rocky Point, NC 28457-9431 — (910) 259-0668
  • 120 Coastal Horizons Dr, Shallotte, NC 28470-6094 — (910) 754-4515
  • 1414 Medical Center Dr, Wilmington, NC 28401-7505 — (910) 790-9949
  • 615 Shipyard Blvd, Wilmington, NC 28412-6431 — (910) 343-0145

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-15641 (NC)

Record details

NPI number1487439089
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 30, 2023
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025

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 Coastal Horizons Center, Inc. — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wilmington