Melrose Ingle Blackett, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0000015010 Issued in TN

Practice address

6215 Humphreys Blvd Ste 300
Memphis, TN 38120-2382

Phone

(901) 757-0229

Fax

(901) 757-9503

NPI assigned

Oct 17, 2006

Last updated

Apr 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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 TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Washington University School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

WT Medical AssociatesGroup PAC ID 1951650613, 64 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.87 of 100Reported as group

Quality

64.75

Promoting interoperability

100

Improvement activities

40

Cost

74.81

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mblackett30088@mlh.direct-ci.com

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.

• WT Medical Associates

  • Internal Medicine Physician
  • Dyersburg, TN
  • NPI 1295223279
  Medicare reassignment Care Compare group
• Baptist Memorial Medical Group Inc

  • Internal Medicine Physician
  • Memphis, TN
  • NPI 1306089206

  Obstetrics & Gynecology

  Medicare reassignment NPD
• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  Care Compare group
• Baptist Memorial Medical Group Inc

  dba BMG East Memphis Pharmacy

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1841006129
  NPD
• WT Medical Associates

  dba West Tennessee Medical Group Primary Care Halls

  • Rural Health Clinic/Center
  • Halls, TN
  • NPI 1356176556
  NPD
• WT Medical Associates

  dba West Tennessee Medical Group Primary Care & Women's Health

  • Rural Health Clinic/Center
  • Dyersburg, TN
  • NPI 1427604198
  NPD
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  NPD (past)
• Baptist Memorial Hospital- Union City Inc

  • General Acute Care Hospital
  • Union City, TN
  • NPI 1114981768
  NPD (past)
• Dyersburg Health

  dba Dyersburg Employee Pharmacy

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1376623819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD STE 103",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209446",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 HUMPHREYS BLVD STE 300",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202382",
            "telephone_number": "901-757-0229",
            "fax_number": "901-757-9503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6225 Humphreys Blvd",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381202373",
            "country_code": "US",
            "telephone_number": "901-227-9103",
            "fax_number": "901-227-9105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKETT",
        "first_name": "MELROSE",
        "middle_name": "INGLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TN",
            "license": "0000015010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Aisha Black, LMSW
• Peyton Saraelizabeth Black, PHARMD
• Dexter Cornelius Blackburn, NURSE
• Ryan Blackburn
• Tyler Ansley Blackburn, DMD
• Tomandra Blackman
• Cassandra Blackmon, RN
• Celisa Rufus Blackmon, PHARMD
• Victoria Elise Blackmon
• Yolanda Ravon Blackmon, RN

• Obstetrics & Gynecology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Obstetrics & Gynecology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.