Individual provider Active NPI

Craig Blakeney, M.D.

  • Emergency Medicine Physician
  • Rochester, MN
National Provider Identifier
1063808749
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
56383 Issued in TN
Practice address
200 1St St SW
Rochester, MN 55905-0001
Phone
(507) 284-2511
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 30394 MS
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 73693 WI
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X 67158 MN
Emergency Medicine Physician 207P00000X 56383 TN Primary

Addresses

Primary practice location

200 1St St SW
Rochester, MN 55905-0001

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Other practice location 1

877 Jefferson Ave
Memphis, TN 38103-2807
Phone (901) 545-7100

Other practice location 2

1265 Union Ave
Memphis, TN 38104-3415
Phone (615) 336-3424

Other names 1

  • Craig Bleakney Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180504002002 TN Practitioner - Emergency Medicine 9638433352 Reassigns benefits to 5 organizations
I20220811000673 MS Practitioner - Emergency Medicine 9638433352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

1995 Hwy 51 S
Covington, TN 38019-3635
Phone (901) 476-2621

6019 Walnut Grove Rd
Memphis, TN 38120-2113
Phone (901) 226-5000

7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone (662) 772-4000

Hospital & facility affiliations

  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131
  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
73693WIMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T M Carr MD PC Emergency Medicine CurrentSince Oct 16, 2017 Accepting new patients
Emergency Coverage, LLC Emergency Medicine CurrentSince Mar 1, 2022 Accepting new patients
Ut Regional One Physicians Inc Emergency Medicine CurrentSince May 19, 2019 Accepting new patients
Carr PLLC Emergency Medicine CurrentSince Oct 16, 2017 Accepting new patients
Ut Regional One Physicians Inc CurrentSince May 19, 2019 Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients

Locations

1995 Highway 51 S
Covington, TN 38019
Phone (901) 476-2621

1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244

7691 Poplar Ave
Memphis, TN 38138
Phone (901) 516-1290

6215 Humphreys Blvd
Ste 201
Memphis, TN 38120
Phone (901) 866-8085

1265 Union Ave
Memphis, TN 38104
Phone (901) 516-2362

3960 New Covington Pike
Memphis, TN 38128
Phone (901) 516-5200

877 Jefferson Ave
Memphis, TN 38103
Phone (901) 448-5893

Interoperability endpoints

  • Direct secure messaging: cblakeney471374@direct.bmhcc.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1063808749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "507-284-2511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "877 Jefferson Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032807",
            "country_code": "US",
            "telephone_number": "901-545-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1265 Union Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381043415",
            "country_code": "US",
            "telephone_number": "615-336-3424",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKENEY",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "30394",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WI",
            "license": "73693",
            "primary": false
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "MN",
            "license": "67158",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "56383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRAIG",
            "last_name": "BLEAKNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.