Bonnie Lynn Blackburn, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

2411 Issued in WV

Practice address

10 Amalia Dr Ste C5
Buckhannon, WV 26201-2270

Phone

(304) 460-7948

Fax

(304) 460-7908

NPI assigned

Mar 15, 2020

Last updated

Sep 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Care of West Virginia, Inc.Group PAC ID 0446232987, 89 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wvuhs Home Care Home health agency, Clarksburg, WV, CCN 517053
• St Joseph's Hospital of Buckhannon, Inc Hospital, Buckhannon, WV, CCN 511321
• West Virginia University Hospitals, Inc Hospital, Morgantown, WV, CCN 510001

Merit-based Incentive Payment System (MIPS)

Final score

95.34 of 100Reported as apm

Quality

79.86

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bonnie.blackburn.1@4803.direct.athenahealth.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.

• Community Care of West Virginia, Inc.

  dba Community Care of Marlinton

  • Federally Qualified Health Center (FQHC)
  • Marlinton, WV
  • NPI 1164653457
  Medicare reassignment Care Compare group NPD
• Community Care of West Virginia Inc

  dba CareXpress of Slaty Fork

  • Federally Qualified Health Center (FQHC)
  • Slatyfork, WV
  • NPI 1215741665
  NPD
• Community Care of West Virginia, Inc.

  dba Pocahontas County High School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Dunmore, WV
  • NPI 1043567456
  NPD
• Community Care of West Virginia, Inc.

  dba Little Birch Elementary School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1053821363
  NPD
• Community Care of West Virginia, Inc.

  dba Community Care Connections of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1063048189
  NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Weston

  • Federally Qualified Health Center (FQHC)
  • Weston, WV
  • NPI 1073944658
  NPD
• Community Care of West Virginia, Inc.

  dba Braxton County Middle School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Sutton, WV
  • NPI 1104175058
  NPD
• Community Care of West Virginia, Inc.

  dba Buckhannon-Upshur High School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1104177674
  NPD
• Community Care of West Virginia, Inc.

  dba Roanoke Elementary School Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Roanoke, WV
  • NPI 1104292168
  NPD
• Community Care of West Virginia, Inc.

  dba CareXpress of Buckhannon

  • Federally Qualified Health Center (FQHC)
  • Buckhannon, WV
  • NPI 1114277050
  NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Bridgeport

  • Community/Behavioral Health Agency
  • Bridgeport, WV
  • NPI 1144811290
  NPD
• Community Care of West Virginia, Inc.

  dba Community Care of Green Bank

  • Federally Qualified Health Center (FQHC)
  • Green Bank, WV
  • NPI 1164557237
  NPD

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

• St Josephs Hospital of Buckhannon Inc

  • Critical Access Hospital
  • Buckhannon, WV
  • NPI 1124005061
  Care Compare affiliation
• West Virginia University Hospitals, Inc

  • General Acute Care Hospital
  • Morgantown, WV
  • NPI 1841271459
  Care Compare affiliation

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

{
    "created_epoch": "1584230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1386270908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AMALIA DR",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012239",
            "telephone_number": "304-473-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 AMALIA DR STE C5",
            "city": "BUCKHANNON",
            "state": "WV",
            "postal_code": "262012270",
            "telephone_number": "304-460-7948",
            "fax_number": "304-460-7908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 Greenway Rd",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234389808",
            "country_code": "US",
            "telephone_number": "757-328-1586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "BONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WV",
            "license": "2411",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of West Virginia, Inc. (Fresenius Medical Care Upshur County)
• Mary Bishop
• Angela Marie Black
• Joyce Black
• Theresa Ann Black, FNP-BC
• Amber R. Blackledge, PA-C
• Mary Blake
• Sandra Blake
• Karen Sue Bland
• Emily Boggs, ATC

• Medical Physician Assistant in Buckhannon, WV
• Providers in Buckhannon, WV by specialty
• Medical Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.