NPIMap

Individual provider Active NPI

Blake Borders

  • Family Nurse Practitioner
  • Benton, MO
National Provider Identifier
1366950693
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2017026029 Issued in MO
Practice address
222 Bland St
Benton, MO 63736-9206
Phone
(573) 427-6027
Fax
(573) 427-6027
NPI assigned
Jan 22, 2018
Last updated
Dec 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2017026029 MO Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180625001098 MO Practitioner - Nurse Practitioner 1355696808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Francis Medical CenterGroup PAC ID 9931007929, 441 clinicians
Internal Medicine Associates of Southeast Missouri LLCGroup PAC ID 5991615072, 43 clinicians

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

Merit-based Incentive Payment System (MIPS)

Final score
67.07 of 100Reported as apm
Quality
85.4
Promoting interoperability
0
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2017026029MOMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Managed Care Inc CurrentSince Jun 1, 2018 Accepting new patients
Saint Francis Medical Center Current Accepting new patients
Saint Francis Medical Center CurrentSince Jan 1, 2022 Accepting new patients
Managed Care Inc CurrentSince Jun 1, 2018 Accepting new patients
Cape Laboratory & Pathology, LC Current Accepting new patients
Saint Francis Medical Center CurrentSince Jan 1, 2022 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

1008 N Main St
Sikeston, MO 63801
Phone (573) 471-1600

808 Hunter Ave
Ste 4
Sikeston, MO 63801
Phone (573) 471-2905

Interoperability endpoints

  • Direct secure messaging: bborders11589@surescripts.sfmc.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1366950693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 BLAND ST",
            "city": "BENTON",
            "state": "MO",
            "postal_code": "637369206",
            "telephone_number": "573-427-6027",
            "fax_number": "573-427-6027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDERS",
        "first_name": "BLAKE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-22",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017026029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, MO

Sources for this page

Verify at the official NPI Registry.