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

Siara Southerland Blackburn

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1063228468

Siara Southerland Blackburn is a Physician Assistant in Wilmington, North Carolina. Qualified in 2025, 1 year ago. Practices with Emergeortho PA, a 724-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
1
Licensed in
NC
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

3787 Shipyard Blvd
Wilmington, NC 28403-6148
Phone: (910) 332-3800
Fax: (910) 251-0421
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Po Box 563, Buies Creek, NC 27506-0563 — (910) 742-7823

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-15739 (NC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1063228468
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 10, 2024
Last updated in NPPESJanuary 18, 2026
Certification dateJanuary 18, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Emergeortho Pa — 724 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Wilmington