Blake William Barnes, M.D.

Key facts

NPI

1477849602

Entity type

Individual (NPI type 1)

Primary specialty

Internal Medicine Physician 207R00000X

License

2011019428 (MO)

Practice address

1 Hospital Dr
Dco58.00
Columbia, MO 65201-5276

Phone

(573) 882-4438

Fax

(573) 884-9992

NPI assigned

Jun 27, 2011

Sex

Male

Sole proprietor

Yes

Organizations & group practices 2

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.

• CH Allied Services, Inc. General Acute Care Hospital · Columbia, MO · NPI 1902817844
  NPD (past)
• Tiger Pediatrics LLC Pediatrics Physician · Columbia, MO · NPI 1871872770
  NPD (past) PEDIATRICS

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Doctor of Medicine

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2012.

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342137600000",
    "number": "1477849602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "DCO58.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "DCO58.00",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652015276",
            "telephone_number": "573-882-4438",
            "fax_number": "573-884-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "BLAKE",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2012-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011019428",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2011019428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

• Renae L Barkema, MED, LPC, LMFT
• Robyn Barlow, FNP-C
• Barnabas Community Supports LLC
• Barnes Health Care Management Group LLC
• Barnes Health LLC
• Christyl Leeann Barnes, RN
• Courtney Leigh Barnes, M.D.
• Emily Dobbins Barnes
• Eric A. Barnes, D.O.
• Janet L Barnes, A-G NP

All providers in Columbia, MO · Internal Medicine Physician in Missouri