Blake Borders
Individual provider Active NPI Family Nurse Practitioner · Benton, MO
NPI 1366950693 · NPPES record last updated Dec 7, 2021
Key facts
- NPI
- 1366950693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2017026029 (MO)
- Practice address
- 222 Bland St
Benton, MO 63736-9206 - Phone
- (573) 427-6027
- Fax
- (573) 427-6027
- NPI assigned
- Jan 22, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 24
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint Francis Medical Center
Internal Medicine Associates of Southeast Missouri LLC
Practice addresses (Care Compare)
211 Saint Francis Dr
Suite 15
Cape Girardeau, MO 63703-5049
Phone (573) 331-3333
225 Physicians Park Dr
Suite 400
Poplar Bluff, MO 63901-3923
Hospital & facility affiliations
- Saint Francis Medical Center
- Poplar Bluff Regional Medical Center
- Mercy Hospital Stoddard
Merit-based Incentive Payment System (MIPS)
- Final score
- 67.07 of 100
- Quality
- 85.4
- Promoting interoperability
- 0
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180625001098 | MO | Practitioner - Nurse Practitioner | 1355696808 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2017026029 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Francis Medical Center | Current |
Accepting new patients | |
| Saint Francis Medical Center | Current | Accepting new patients | |
| Cape Laboratory & Pathology, LC | Current | Accepting new patients | |
| Managed Care Inc | Current |
Accepting new patients | |
| Saint Francis Medical Center | Current |
Accepting new patients | |
| Managed Care Inc | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
Locations
211 Saint Francis Dr
Ste 15
Cape Girardeau, MO 63703
Phone (573) 331-3333
211 Saint Francis Dr
Cpe Girardeau, MO 63703
Phone (573) 331-3000
1212 Saint Francis Dr
Dexter, MO 63841
Phone (573) 614-3600
515 Maple Valley Dr
Farmington, MO 63640
Phone (573) 760-7920
420 Piedmont Ave
Piedmont, MO 63957
Phone (573) 223-2526
225 Physicians Park
Ste 400
Poplar Bluff, MO 63901
Phone (573) 785-7721
808 Hunter Ave
Ste 4
Sikeston, MO 63801
Phone (573) 471-2905
1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600
Interoperability endpoints
- bborders11589@surescripts.sfmc.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2017026029 | MO | Yes |
Addresses
Primary practice location
222 Bland St
Benton, MO 63736-9206
Mailing address
PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583
Other providers in Benton, MO
- A & a in-Home Health Care, LLC
- Lana Jean Atkins
- Jaimie Suzanne Cannon
- Comprehensive Family Health Care LLC
- Missouri Delta Medical Center
- Missouri Delta Medical Center
- Jessica Pickel
All providers in Benton, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.