Individual provider Active NPI

Blair Shaw Ritchie, PA-C

  • Physician Assistant
  • Indianapolis, IN
National Provider Identifier
1366282071
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
8111 S Emerson Ave
Indianapolis, IN 46237-8601
Phone
(317) 528-5261
NPI assigned
May 30, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IN Primary

Addresses

Primary practice location

8111 S Emerson Ave
Indianapolis, IN 46237-8601

Mailing address

8111 S Emerson Ave
Indianapolis, IN 46237-8601

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241010001650 IN Practitioner - Physician Assistant 3779015128 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1366282071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 S EMERSON AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378601",
            "telephone_number": "317-528-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RITCHIE",
        "first_name": "BLAIR",
        "middle_name": "SHAW",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.