Siara Southerland Blackburn is a Physician Assistant practicing in Wilmington, North Carolina. The National Provider Identifier (NPI) is #1063228468, which was assigned on December 10, 2024, and the registration record was last updated on January 18, 2026. The practitioner's main practice location is at 3787 Shipyard Blvd, Wilmington, NC 28403-6148; the contact telephone number is 9103323800, and the fax number is 9102510421. The primary taxonomy of Siara Southerland Blackburn is Physician Assistant (363A00000X). Siara Southerland Blackburn is licensed to practice in the state of North Carolina (#0010-15739).
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
| NPI | 1063228468 |
| Entity Type | Individual |
| Provider Name | SIARA SOUTHERLAND BLACKBURN |
| Other Name |
SIARA NICOLE SOUTHERLAND (Former Name) |
| Gender | Female |
| Practice Address |
3787 Shipyard Blvd Wilmington NC 28403-6148 |
| Practice Telephone | 9103323800 |
| Practice Fax Number | 9102510421 |
| Mailing Address |
Po Box 5105 Belfast ME 04915-5100 |
| Mailing Telephone | 9103323800 |
| Mailing Fax Number | 9102510421 |
| Certification Date | 2026-01-18 |
| Enumeration Date | 2024-12-10 |
| Last Update Date | 2026-01-18 |
| Is Sole Proprietor | N |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| N | 390200000X | Student in an Organized Health Care Education/Training Program | ||||
| Y | 363A00000X | Physician Assistant | 0010-15739 | NC |
| Address | Telephone | Fax |
|---|---|---|
| PO Box 563, Buies Creek, NC 275060563 | 9107427823 |
| Code | 363A00000X |
| Taxonomy | Physician Assistant |
| Classification | Physician Assistant |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| Classification | Student in an Organized Health Care Education/Training Program |
| Grouping | Student, Health Care |
| Definition: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Belle Grove Physician Services, LLC | 351 Valley Health Way, Front Royal, VA 22630-3598 | Physician Assistant | 2026-04-10 |
| Martin Andres Vera | 650 Joel Dr, Fort Campbell, KY 42223-8355 | Physician Assistant | 2026-04-11 |
| Sarah Nu Chi Wright | 5107 College Center Dr, Fayetteville, NC 28311-1463 | Physician Assistant | 2026-04-11 |
| Cacapon Physician Services, PLLC | 363 Sunrise Blvd, Romney, WV 26757-4607 | Physician Assistant | 2026-04-10 |
| Ella Ruth Sweeney | 900 South Limestone, Lexington, KY 40536-0200 | Physician Assistant | 2026-04-10 |
| Sarah Madison Chalstrom | 9003 E Shea Blvd, Scottsdale, AZ 85260-6709 | Physician Assistant | 2026-04-10 |
| Katerina Vignau | 12330 Sw 22nd Ter, Miami, FL 33175-7701 | Physician Assistant | 2026-04-11 |
| Brandon J Lafever | 43 New Scotland Ave, Albany, NY 12208-3478 | Physician Assistant | 2026-04-11 |
| Mission Emergency Medicine Services, Pa | 2827 Babcock Rd, San Antonio, TX 78229-4813 | Physician Assistant | 2026-04-10 |
| Lillian Duval | 13710 St. Francis Boulevard, Tower C, Suite 505, Midlothian, VA 23114 | Physician Assistant | 2026-04-10 |
| Find all providers with the same taxonomy | |||
| Street Address |
3787 SHIPYARD BLVD |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28403-6148 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kennedy Selby | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Physician Assistant | 2025-10-21 |
| Glenn Alan Miller Jr. | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Physician Assistant | 2007-02-12 |
| Scott Everett Dart | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Orthopaedic Surgery Physician | 2015-04-07 |
| Darrin Franklin Eakins | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Orthopaedic Surgery Physician | 2006-04-25 |
| Zachary Robert Diltz | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Orthopaedic Surgery Physician | 2019-04-12 |
| Leeanna Rae Tupek | 3787 Shipyard Blvd, Wilmington, NC 28403-6148 | Physician Assistant | 2025-06-30 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Alexandra Elaine Taylor | 240 Racine Drive Suite 100, Wilmington, NC 28403 | Behavioral Analyst | 2019-04-25 |
| Siena Sallustio | 3015 Market St, Wilmington, NC 28403-0724 | Behavior Technician | 2026-03-10 |
| Kiana Andarowski | 3015 Market St, Wilmington, NC 28403-0724 | Behavior Technician | 2026-03-30 |
| Kathryn Love Ormsby | 2527 Delaney Ave, Ste C, Wilmington, NC 28403 | Hand Occupational Therapist | 2006-04-19 |
| William Eliason Sisson Jr. | 4706 Oleander Drive, Wilmington, NC 28403 | Chiropractor | 2006-07-16 |
| Liberty Commons Nursing Center Inc | 121 Racine Dr, Wilmington, NC 28403 | Skilled Nursing Facility | 2006-05-20 |
| Rita D Katz | 6303 Oleander Dr, Cape Fear Counseling & Psychotherapy, Wilmington, NC 28403 | Psychologist | 2006-07-28 |
| Emily Michalina Corbo | 5505 Currituck Dr, Suite 200, Wilmington, NC 28403 | Physician Assistant | 2019-03-05 |
| Katherine Dickson | 3015 Market St, Wilmington, NC 28403-0724 | Behavior Technician | 2025-11-17 |
| Jasmin Gore | 3015 Market St, Wilmington, NC 28403-0724 | Behavior Technician | 2026-03-30 |
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| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Kristina Southerland | 10604 Southwest Hwy Ste 101, Chicago Ridge, IL 60415-2704 | Nurse Practitioner | 2019-10-15 |
| Southerland Opco LLC | 333 Maple St, Sutherland, NE 69165-3000 | Skilled Nursing Facility | 2025-12-15 |
| Thomas S Southerland | 2000 S Pine St, Spartanburg, SC 29302-3315 | Pharmacist | 2025-08-09 |
| Siara Jones | 6419 W Loop 1604 N Ste 108, San Antonio, TX 78254-5764 | Behavior Technician | 2026-03-05 |
| Kimberly Meehan Siara | Po Box 339, Peapack, NJ 07977-0339 | Physical Rehabilitation Occupational Therapist | 2025-11-11 |
| Siara Campbell | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381-5629 | Student in an Organized Health Care Education/Training Program | 2024-09-09 |
| Siara Morrison · Siara Smith | 3231 N 26th Ave, Omaha, NE 68111-3213 | Phlebotomy Technician | 2025-10-30 |
| Siara J Killebrew | 4354 N Kenmore Rd, Indianapolis, IN 46226-3584 | Home Health Agency | 2025-07-15 |
| Siara Farrar | 77 E Woodbury Dr, Dayton, OH 45415-2855 | Case Manager/Care Coordinator | 2025-08-04 |
| Robert Southerland | 1830 County Route 64, Salem, NY 12865-3404 | Family Medicine Physician | 2017-04-18 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |