Individual provider Active NPI

Michele Deann Blair, APRN, NP-C

  • Nurse Practitioner
  • Madisonville, KY
National Provider Identifier
1073055901
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3010855 Issued in KY
Practice address
200 Clinic Dr # 6
Madisonville, KY 42431-1661
Phone
(812) 477-7246
Fax
(270) 554-8987
NPI assigned
Nov 9, 2016
Last updated
Nov 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3010855 KY Primary
Interventional Pain Medicine Physician 208VP0014X 3010855 KY

Addresses

Primary practice location

200 Clinic Dr # 6
Madisonville, KY 42431-1661

Mailing address

67 Lakeview Dr
Paducah, KY 42001-5619
Phone (270) 554-8373

Other practice location 1

3332 Villa Pt Ste 104
Owensboro, KY 42303-7818
Phone (812) 477-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161219002840 KY Practitioner - Nurse Practitioner 5395026926 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

3332 Villa PT
Suite 104
Owensboro, KY 42303-7818
Phone (812) 477-7246

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3010855KYMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Care Clinic PSC Interventional Pain Medicine CurrentSince Jan 1, 2026 Accepting new patients
Pain Management Centers of America, PSC Interventional Pain Medicine CurrentSince Aug 10, 2020 Accepting new patients
Pain Management Centers of America, PSC Interventional Pain Medicine Past Accepting new patients
Advanced Pain Care Clinic Interventional Pain Medicine Past Accepting new patients

Locations

1101 Professional Blvd
Ste 210
Evansville, IN 47714
Phone (812) 214-4099

112 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 554-8373

1195 S Main St
#D
Madisonville, KY 42431
Phone (812) 505-2164

200 Clinic Dr
#6
Madisonville, KY 42431

200 Clinic Dr
Fl 3
Madisonville, KY 42431
Phone (270) 825-7214

200 Clinic Dr
Fl 6
Madisonville, KY 42431
Phone (270) 554-8373

3332 Villa Pt
Ste 104
Owensboro, KY 42303
Phone (270) 594-4892

67 Lakeview Dr
Paducah, KY 42001
Phone (270) 554-8373

6426 Highway 51 N
Ste B
Horn Lake, MS 38637
Phone (662) 440-7246

Organizations & group practices 5

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

Hospital & facility affiliations 1

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1073055901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 LAKEVIEW DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420015619",
            "telephone_number": "270-554-8373",
            "fax_number": "270-554-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR # 6",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "812-477-7246",
            "fax_number": "270-554-8987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3332 Villa Pt Ste 104",
            "address_purpose": "LOCATION",
            "city": "Owensboro",
            "state": "KY",
            "postal_code": "423037818",
            "country_code": "US",
            "telephone_number": "812-477-7246",
            "fax_number": "270-554-8987",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "MICHELE",
        "middle_name": "DEANN",
        "credential": "APRN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-09",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010855",
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "KY",
            "license": "3010855",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, KY

Sources for this page

Verify at the official NPI Registry.