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

Zachary Ian Blake

Individual provider Physician Assistant · NPI 1447901665

Zachary Ian Blake is a Physician Assistant in Wilmington, North Carolina. Qualified in 2023, 3 years ago. Practices with Novant Health Medical Group Coastal Region LLC, a 576-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina and West Virginia.

Years since qualifying
3
Licensed in
NC, WV
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

2131 S 17th St
Wilmington, NC 28401-7407
Phone: (910) 667-2606
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3200 Maccorkle Ave, Se, Suite B-16, Charleston, WV 25304 — (304) 388-5848

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-15439 (NC)
Physician Assistant Taxonomy 363A00000X · Licence 2726 (WV)

Record details

NPI number1447901665
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 11, 2022
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Novant Health Medical Group Coastal Region Llc — 576 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Wilmington