Individual provider Active NPI

John Blakely Isbell, M.D.

  • Obstetrics & Gynecology Physician
  • Fort Payne, AL
National Provider Identifier
1487608204
Registry record updated Apr 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
9925 Issued in AL
Practice address
550 Medical Center Dr SW
Fort Payne, AL 35968-3418
Phone
(256) 845-8885
Fax
(256) 845-9546
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 9925 AL Primary

Addresses

Primary practice location

550 Medical Center Dr SW
Fort Payne, AL 35968-3418

Mailing address

550 Medical Center Dr SW
PO Box 680199
Fort Payne, AL 35968-3418
Phone (256) 845-8885

Other identifiers 2

IdentifierTypeStateIssuer
000011706MedicaidAL
11706OtherALBCBS

Other names 1

  • Blake Isbell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20051017000955 AL Practitioner - Obstetrics/Gynecology 6406843960 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
952ALMDCounseling Psychologist
9925ALMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Isbell Medical Group, P.C. Obstetrics & Gynecology CurrentSince Oct 1, 1985 Accepting new patients

Locations

550 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 845-6293

Interoperability endpoints

  • Direct secure messaging: bisbell@yourcarecommunity.org

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Isbell Medical Group PCFort Payne, AL, CCN 018932 Rural health clinic 5% Or Greater Direct Ownership Interest (20%)
W-2 Managing Employee
Feb 1, 2018
Feb 1, 2018

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522886400000",
    "number": "1487608204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "address_2": "PO BOX 680199",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MEDICAL CENTER DR SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359683418",
            "telephone_number": "256-845-8885",
            "fax_number": "256-845-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISBELL",
        "first_name": "JOHN",
        "middle_name": "BLAKELY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2018-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "AL",
            "license": "9925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000011706",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "11706",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "ISBELL",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Payne, AL

Sources for this page

Verify at the official NPI Registry.