Robert V Blakeburn MD PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

17199 Issued in OK

Legal business name

ROBERT V BLAKEBURN MD PC

Practice address

800 Frisco Ave
Clinton, OK 73601-3306

Phone

(580) 323-2700

Fax

(580) 323-2718

NPI assigned

Sep 30, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Robert Van Blakeburn, MDNPI 1164419560

Title

President/Owner

Phone

(580) 323-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Van Blakeburn, MD

  • Family Medicine Physician
  • Santa Fe, NM
  • NPI 1164419560

  OK

  Medicare reassignment Care Compare group NPD Authorized official
• Chandra Leigh Ake, ARNP

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1649745522
  Medicare reassignment Care Compare group NPD
• Kyle Edwards, APRN FNP-C

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1790260511
  Medicare reassignment Care Compare group NPD
• Mark Blaine Mann, M.D.

  • Family Medicine Physician
  • Yukon, OK
  • NPI 1184649584
  Medicare reassignment Care Compare group NPD
• Ashley Dawn Morris, APRN, NP-C

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1245586924
  Medicare reassignment Care Compare group NPD
• Jessica Simmons, APRN, FNP-BC

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1174108518
  Medicare reassignment Care Compare group NPD
• Kerby Lamb, DO

  • Family Medicine Physician
  • Weatherford, OK
  • NPI 1639122369
  Medicare reassignment NPD
• Angela Dawn Pope-Bailey, ARNP

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1629209721
  Medicare reassignment NPD
• Ginger Lynn Woodall, ARNP-CNP

  • Family Nurse Practitioner
  • Clinton, OK
  • NPI 1295036838
  NPD (past)
• Blane Mitchell Crandall, M.D.

  • Obstetrics & Gynecology Physician
  • Naples, FL
  • NPI 1619057395
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775001600000",
    "number": "1033106448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 FRISCO AVE",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736013306",
            "telephone_number": "580-323-2700",
            "fax_number": "580-323-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 FRISCO AVE",
            "city": "CLINTON",
            "state": "OK",
            "postal_code": "736013306",
            "telephone_number": "580-323-2700",
            "fax_number": "580-323-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT V BLAKEBURN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-30",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A",
        "authorized_official_last_name": "BLAKEBURN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "580-323-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "17199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100110960C",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Elaine Reid, R.N.
• Renal Treatment Centers West Inc (Clinton Dialysis Center)
• Roberto Reyes, DMD
• Richard B. Madden, O.D.
• Deonda Roberson, RN
• Karen Robinson
• Kala Rodgers, AUD
• Patricia F. Rodgers, PHARMD
• Billie Rodriguez
• Linda Sue Rogers

• Family Medicine Physician in Clinton, OK
• Providers in Clinton, OK by specialty
• Family Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.