Individual provider Active NPI

Kevin Michael Blackwood, M.D.

  • Anesthesiology Physician
  • Baton Rouge, LA
National Provider Identifier
1538468426
Registry record updated Oct 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
301615 Issued in LA
Practice address
7777 Hennessy Blvd Ste 301
Baton Rouge, LA 70808-0319
Phone
(225) 214-6438
NPI assigned
Mar 18, 2011
Last updated
Oct 17, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2017

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 301615 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 301
Baton Rouge, LA 70808-0319

Mailing address

7777 Hennessy Blvd Ste 301
Baton Rouge, LA 70808-0319
Phone (225) 214-6438

Other identifiers 1

IdentifierTypeStateIssuer
2149733MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20160927000277 LA Practitioner - Anesthesiology 0345537874 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Group Associates Inc CurrentSince Aug 10, 2016 Accepting new patients
Zephyr Anesthesia, LLC Anesthesiology CurrentSince May 27, 2024 Accepting new patients
Youngs Professional Services LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

11414 Lake Sherwood Ave N
Baton Rouge, LA 70816
Phone (225) 532-4058

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

7310 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 236-3100

7777 Hennessy Blvd
Ste 301
Baton Rouge, LA 70808
Phone (225) 214-6436

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

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.

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1538468426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 301",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708080319",
            "telephone_number": "225-214-6438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 301",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708080319",
            "telephone_number": "225-214-6438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWOOD",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-18",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "LA",
            "license": "301615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2149733",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.