Cody Blackwelder, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

341995 Issued in LA

Practice address

1200 S Farmerville St
Ruston, LA 71270-5941

Phone

(318) 255-3690

NPI assigned

Apr 22, 2019

Last updated

Oct 10, 2024By 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

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

Specialty

General Surgery

Education

Louisiana State University School of Medicine in New Orleans, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Green Clinic LLCGroup PAC ID 4789668831, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northern Louisiana Medical Center Hospital, Ruston, LA, CCN 190086
• Glenwood Regional Medical Center Hospital, West Monroe, LA, CCN 190160
• Monroe Surgical Hospital Hospital, Monroe, LA, CCN 190245

Merit-based Incentive Payment System (MIPS)

Final score

81.51 of 100Reported as apm

Quality

60.04

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Green Clinic LLC

  • Family Medicine Physician
  • Ruston, LA
  • NPI 1831178755
  Medicare reassignment Care Compare group NPD
• CLHG-Winn, LLC

  dba Winn Parish Medical Center Physician Practice

  • Family Medicine Physician
  • Winnfield, LA
  • NPI 1629391628

  Surgery

  Medicare reassignment NPD
• Northern Louisiana Emergency Physicians, LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Ruston, LA
  • NPI 1588828172
  Medicare reassignment NPD
• CLHG-Winn LLC

  dba Winn Rural Health

  • Rural Health Clinic/Center
  • Winnfield, LA
  • NPI 1467055442
  NPD
• Green Clinic LLC

  dba Quickcare of Ruston

  • Rural Health Clinic/Center
  • Ruston, LA
  • NPI 1578021093
  NPD
• Northern Louisiana Emergency Physicians LLP

  dba Northern Louisiana Physicians LLP

  • Emergency Medicine Physician
  • Winnfield, LA
  • NPI 1497085690
  NPD

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

• CLHG-Ruston LLC

  dba Northern Louisiana Medical Center

  • General Acute Care Hospital
  • Ruston, LA
  • NPI 1962024026
  Care Compare affiliation
• Hsa Glenwood, LLC

  • General Acute Care Hospital
  • West Monroe, LA
  • NPI 1548083421
  Care Compare affiliation
• Monroe Surgical Hospital, LLC

  • General Acute Care Hospital
  • Monroe, LA
  • NPI 1225031495
  Care Compare affiliation

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1548824873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-255-3690",
            "fax_number": "318-232-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S FARMERVILLE ST",
            "city": "RUSTON",
            "state": "LA",
            "postal_code": "712705941",
            "telephone_number": "318-255-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELDER",
        "first_name": "CODY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "341995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Louisiana, LLC (Fresenius Medical Care of Ruston)
• Bio-Medical Applications of Louisiana, LLC (Lincoln Kidney Center)
• Ashlynn Bishop
• Robert Marcus Black, RPH
• Aimee Blackham, PHD
• Mark Blackwelder, M.D.
• Allie Blackwood, DNP, CRNA
• Madeline Kate Blundell, CCC-SLP
• Boersma Clinic, LLC
• Taylor Blake Boggs, APRN, FNP-C

• Surgery Physician in Ruston, LA
• Providers in Ruston, LA by specialty
• Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.