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

Randal Blake, PA-C, MPAS

Individual provider Physician Assistant · NPI 1598479370

Randal Blake, PA-C, MPAS is a Physician Assistant in Fort Bragg, North Carolina. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
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

2817 Rock Merritt Ave
Fort Bragg, NC 28310-4504
Phone: (910) 907-8922
Fax: (910) 907-6069
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 1204584
Physician Assistant Taxonomy 363A00000X · Licence 1598479370

Record details

NPI number1598479370
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , MPAS
Sole proprietorNo
NPI enumeratedJanuary 6, 2023
Last updated in NPPESDecember 2, 2025
Certification dateDecember 2, 2025

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