Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ruby Amanda Stipe Blaylock, PA-C

Individual provider Physician Assistant · NPI 1184000234

Ruby Amanda Stipe Blaylock, PA-C is a Physician Assistant in Durham, North Carolina. Qualified in 2015, 11 years ago. Practices with Millennium Physician Group of Nc, PLLC, a 27-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
11
Licensed in
NC
In the registry since
2015
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

4205 Ben Franklin Blvd
Durham, NC 27704-2143
Phone: (919) 477-6900
Fax: (919) 620-0974
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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 001006690 (NC)

Record details

NPI number1184000234
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 30, 2015
Last updated in NPPESFebruary 28, 2025
Certification dateFebruary 28, 2025
Mailing address2675 Winkler Ave Fl 2, Fort Myers, FL 33901-9342

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Millennium Physician Group Of Nc, Pllc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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