Active NPI
William E Blackburn, MD
- Urology Physician
- Lexington, KY
National Provider Identifier
1124025101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 15471
- Practice address
- 1760 Nicholasville Rd
Suite 301
Lexington, KY 40503-1471 - Phone
- (859) 277-5766
- Fax
- (859) 277-3406
- NPI assigned
- Jul 5, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 15471 | KY | Primary |
Addresses
Primary practice location
1760 Nicholasville Rd
Suite 301
Lexington, KY 40503-1471
Mailing address
1760 Nicholasville Rd
Suite 301
Lexington, KY 40503-1471
Phone (859) 277-5766
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64154719 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15471 | KY | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205193600000",
"number": "1124025101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1760 NICHOLASVILLE RD",
"address_2": "SUITE 301",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031471",
"telephone_number": "859-277-5766",
"fax_number": "859-277-3406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1760 NICHOLASVILLE RD",
"address_2": "SUITE 301",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031471",
"telephone_number": "859-277-5766",
"fax_number": "859-277-3406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKBURN",
"first_name": "WILLIAM",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-05",
"last_updated": "2008-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KY",
"license": "15471",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64154719",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
- Peter Blackburn, MD
- Rachel Ann Blackburn, M.ED., BCBA, LBA
- Rodney Buddy Blackburn, PHARMD
- Sarah Lee Ann Blackburn
- Sean M Blackburn, LCSW
- Yuliya Mikhaylovna Blackburn, PHARM D
- Audrey Nicole Blacketer, CF
- Camille Francoise Michelle Blackman, MD
- Chelsea Blackman, LPCA
- Emily Madden Duncan Blackman, CRNA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.