Individual provider Active NPI

David Michael Blackwell II, MD

  • Family Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1104903111
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01047203A Issued in IN
Practice address
907 N East St
Indianapolis, IN 46202-3425
Phone
(317) 644-3461
Fax
(317) 602-2654
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 8

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 5

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

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLC 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Hospital & facility affiliations

  • Anchor of Hope Hospice Hospice, Carmel, IN, CCN 151654
  • Legacy Hospice LLC Hospice, Carmel, IN, CCN 151666
  • Anew Hospice Hospice, Indianapolis, IN, CCN 151619
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health North Hospital Hospital, Carmel, IN, CCN 150161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000872 IN Practitioner - Family Practice 8921055708 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01047203INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. Family Medicine CurrentSince Mar 1, 2024 Accepting new patients
University Family Physicians, Inc. CurrentSince Mar 1, 2024 Accepting new patients
Iu Health Medical Group, LLC CurrentSince Jul 1, 2025 Accepting new patients
Community Health Network, Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Community Hospitals of Indiana Inc Family Medicine Past Accepting new patients
Major Hospital Past Accepting new patients
Wellcare Family Medicine PC Family Medicine Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

2625 E 62nd St
Ste 2010
Indianapolis, IN 46220
Phone (317) 251-6121

9757 Westpoint Dr
Ste 100
Indianapolis, IN 46256
Phone (317) 577-2779

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: dblackwell4@direct.iuhealth.org
  • Direct secure messaging: dblackwell@direct.iuhealth.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01047203 IN
Family Medicine Physician 207Q00000X 01047203A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

907 N East St
Indianapolis, IN 46202-3425

Mailing address

907 N East St
Indianapolis, IN 46202-3425
Phone (317) 644-3461

Other practice location 1

2625 E 62nd St Ste 2010
Indianapolis, IN 46220-0037
Phone (317) 216-2800

Other practice location 2

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
1102455200OtherINANTHEM PTAN
300087633MedicaidIN

Electronic endpoints 2

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address dblackwell@direct.iuhealth.org Direct
Direct Messaging Address dblackwell@direct.iuhealth.org Direct

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 15, 2025.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1104903111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 N EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023425",
            "telephone_number": "317-644-3461",
            "fax_number": "317-602-2654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N EAST ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023425",
            "telephone_number": "317-644-3461",
            "fax_number": "317-602-2654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 E 62nd St Ste 2010",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462200037",
            "country_code": "US",
            "telephone_number": "317-216-2800",
            "fax_number": "317-216-2777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1701 N Senate Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462021239",
            "country_code": "US",
            "telephone_number": "888-484-3258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047203",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01047203A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PTAN",
            "identifier": "1102455200",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300087633",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblackwell@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2625 E 62nd St Ste 2010",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462200037",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dblackwell@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1701 N Senate Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462021239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.