Vaughn Daniel Blackburn, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36003708 Issued in OH

Practice address

5 W Main St
Amelia, OH 45102-1924

Phone

(513) 753-0500

Fax

(513) 986-0218

NPI assigned

Sep 7, 2011

Last updated

Feb 12, 2020By 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

Other identifiers 3

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Health - Fairfield Hospital Hospital, Fairfield, OH, CCN 360056
• Mercy Health - Clermont Hospital Hospital, Batavia, OH, CCN 360236
• Mercy Health - West Hospital Hospital, Cincinnati, OH, CCN 360234

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vaughn Blackburn DPM LLC

  • Podiatrist
  • Amelia, OH
  • NPI 1437531829
  Medicare reassignment NPD Authorized official
• Neil Blackburn DDS, Inc.

  • Dentist
  • Amelia, OH
  • NPI 1508234030
  NPD (past)

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

• Mercy Health - Clermont Hospital LLC

  dba Clermont Hospital

  • General Acute Care Hospital
  • Batavia, OH
  • NPI 1568562551
  Care Compare affiliation
• Mercy Health - Fairfield Hospital LLC

  dba Mercy Health - Fairfield Hospital

  • General Acute Care Hospital
  • Fairfield, OH
  • NPI 1467552471
  Care Compare affiliation
• Mercy Health - West Hospital LLC

  dba Mercy Health - West Hospital

  • General Acute Care Hospital
  • Cincinnati, OH
  • NPI 1912007931
  Care Compare affiliation
• Mercy Health - West Hospital LLC

  dba Mercy Health - West Hospital

  • Clinical Medical Laboratory
  • Cincinnati, OH
  • NPI 1982728036

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1386925170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PLEASANT AVE",
            "address_2": "SUITE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144670",
            "telephone_number": "513-829-9333",
            "fax_number": "513-858-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 W MAIN ST",
            "city": "AMELIA",
            "state": "OH",
            "postal_code": "451021924",
            "telephone_number": "513-753-0500",
            "fax_number": "513-986-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "VAUGHN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-07",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0119172",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100441710",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201371230",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Bevins, ATC
• Kathy Bidding
• Joseph McKenzie Biesiada, ED. S.
• Olivia Yvette Billings, LPN
• Neil Blackburn, DDS
• Connie Bowling, RN
• Nicole Boyer
• Kelli Jo Bradford, PEER SUPPRT
• Mariah Dawn Brewer
• Carmen Nicole Brock

• Podiatrist in Amelia, OH
• Providers in Amelia, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.