SHIRLEY R BLAKE, M.S. — NPI 1467988360 (Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) in BRISTOL, VA)

CMS-1500 Box 24J / 33a • NPI

1467988360

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

174400000X

Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)

Box 32 Service Location & ZIP+4

24063 HIGHPOINT RD, BRISTOL, VA, 24202-4707

✓ 9-Digit EDI 837 ZIP+4 (24202-4707)

Practice Phone & Referral Fax

(276) 971-0079

Fax: (276) 591-5353

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1467988360 (SHIRLEY R BLAKE, M.S.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1467988360` (NPI-1 Individual Practitioner)
Provider / Legal Name	SHIRLEY R BLAKE, M.S.
Plain-English Specialty	Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: `174400000X` (Specialist)
Certifying / Licensing Body	American Board of Pediatrics (ABP)
Practice Location Address	24063 HIGHPOINT RD, BRISTOL, VA, 24202-4707
Practice Telephone / Fax	Tel: (276) 971-0079 \| Fax: (276) 591-5353
Administrative Mailing Address	24063 HIGHPOINT RD, BRISTOL, VA, 24202-4707
Enumeration & Last Sync	Enumerated: 2017-05-11 \| CMS Record Updated: 2017-05-11

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

24063 HIGHPOINT RD, BRISTOL, VA, 24202-4707

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Plain-English Taxonomy & CMS Crosswalk (174400000X)

What Does Taxonomy Code 174400000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 174400000X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: American Board of Pediatrics (ABP)
Clinical Scope: Newborn jaundice screening, routine childhood vaccinations, developmental milestones, pediatric fevers, ear infections, asthma, or acute gastroenteritis.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (SHIRLEY R BLAKE, M.S.)

Typical CPT / Diagnostic Procedures:

Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
Pediatric Asthma Nebulization & Spirometry Evaluation

Common Therapeutic Classes:

Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171R00000X` — Interpreter Plain English: Licensed & Credentialed Interpreter	State: VA \| License: `Verified` \| Primary: Secondary
`174400000X` — Specialist Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: VA \| License: `PGP-127280` \| Primary: Yes (Primary)
`405300000X` — Prevention Professional Plain English: Licensed & Credentialed Prevention Professional	State: VA \| License: `10,545` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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SHIRLEY R BLAKE, M.S. (NPI #1467988360)