NPIMap

Individual provider Active NPI

Ross McCord Blackshear, MD

  • Anesthesiology Physician
  • Springfield, MO
National Provider Identifier
1417453531
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
2022026374 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-6863
NPI assigned
Apr 5, 2018
Last updated
Jul 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2022026374 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

449 S Oaks Dr
Springfield, MO 65809-1101
Phone (417) 860-5549

Other practice location 1

4301 W Markham St # 515
Little Rock, AR 72205-7101
Phone (501) 603-1656

Other practice location 2

1 Childrens Way # 203
Little Rock, AR 72202-3500
Phone (501) 364-2913

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
I20220802003062 MO Practitioner - Anesthesiology 0648526277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arkansas College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1229 E Seminole
230 MC Pulmonology ASC
Springfield, MO 65804-2227
Phone (417) 888-6711

1229 E Seminole St
Springfield, MO 65804-2227

1229 E Seminole St FL
2 MC Spine Orthopedics Springfield
Springfield, MO 65804-2227
Phone (417) 820-2064

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

3045 S National Ave
Springfield, MO 65804-4268

3050 E River Bluff Blvd
MC Orthopedics
Ozark, MO 65721-8807
Phone (417) 820-5610

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2022026374MOMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital Springfield Current Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 25, 2022 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 25, 2022 Accepting new patients

Locations

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Organizations & group practices 3

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 9

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1417453531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 S OAKS DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658091101",
            "telephone_number": "417-860-5549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-6863"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St # 515",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-603-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Way # 203",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-2913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKSHEAR",
        "first_name": "ROSS",
        "middle_name": "MCCORD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2022026374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.