Keith Allen Blakely, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

052152 Issued in OH

Practice address

237 W Schrock Rd
Westerville, OH 43081-2874

Phone

(614) 627-1410

Fax

(614) 627-1413

NPI assigned

Jan 23, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Family Practice

Education

University of Cincinnati College of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mount Carmel Healthproviders IncGroup PAC ID 9537073804, 140 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mount Carmel East & West Hospital, Columbus, OH, CCN 360035
• Mount Carmel St Ann'S Hospital, Westerville, OH, CCN 360012
• Grant Medical Center Hospital, Columbus, OH, CCN 360017
• Mount Carmel Dublin Hospital, Dublin, OH, CCN 360375
• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kblakely1153807@direct.trinity-health.org

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.

• Mount Carmel Healthproviders Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1356384143
  Medicare reassignment Care Compare group NPD
• Mount Carmel Health Providers Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1831364876
  NPD
• Mount Carmel Health Providers Inc

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1184899122
  NPD (past)
• Mount Carmel Healthproviders Two LLC

  • Surgery Physician
  • Columbus, OH
  • NPI 1528203981
  NPD (past)

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

• Mount Carmel Health System

  • General Acute Care Hospital
  • Westerville, OH
  • NPI 1417037045
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Grove City, OH
  • NPI 1710067376
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Dublin, OH
  • NPI 1710752183
  Care Compare affiliation
• Mount Carmel Health System

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1982784534
  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1255377149
  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972
  Care Compare affiliation
• Ohiohealth Corporation

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1386799237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 W SCHROCK RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812874",
            "telephone_number": "614-627-1410",
            "fax_number": "614-627-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 W SCHROCK RD",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430812874",
            "telephone_number": "614-627-1410",
            "fax_number": "614-627-1413"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6200 Cleveland Ave",
            "address_2": "suite101",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432318608",
            "country_code": "US",
            "telephone_number": "614-898-0150",
            "fax_number": "614-898-0694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "KEITH",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "052152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblakely1153807@direct.trinity-health.org",
            "affiliation": "N",
            "endpointDescription": "Mount Carmel Health Columbus Direct Address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "237 W Schrock Rd",
            "city": "Westerville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430812874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Douglas Ross Black, D.C.
• Princess Black, PSY.D.
• Renee J Black, OTR/L
• Theresa Joy Black, LISW-S
• Barbara Blair-Karr, MSW
• Emily Blaner
• Jeffrey A Blankenbeckler, DDS
• Ian Blasczyk
• Sarah Blasczyk
• Denise L Blocker, MD

• Family Medicine Physician in Westerville, OH
• Providers in Westerville, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.