Donald Edward Blackburn, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3016712 Issued in KY

Practice address

2000 Ring Rd
Elizabethtown, KY 42701-9454

Phone

(270) 506-2730

Fax

(270) 900-0704

NPI assigned

Sep 27, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Astra Behavioral Health LLC

  • Psychiatry Physician
  • Elizabethtown, KY
  • NPI 1922427517

  KY, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1174294227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7818 PEAR VIEW LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402184761",
            "telephone_number": "502-552-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RING RD",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019454",
            "telephone_number": "270-506-2730",
            "fax_number": "270-900-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "DONALD",
        "middle_name": "EDWARD",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3016712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Biren Desai MD PSC
• Brooke Bischoff, APRN, PMHNP
• Jennifer Bischoff, OTR/L
• Lily Gayle Black
• Tracy Diane Black, M.S. CF-SLP
• Chelsea Blair, APSS
• Erika Sparks Blair, APRN
• Joshua Michael Blair, APSS
• Zachary Blair, APSS
• Alisha Blais, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.