Michael Lowell Blackburn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA934 Issued in KY

Practice address

3480 Yorkshire Medical Park
Lexington, KY 40509-1886

Phone

(859) 263-5140

NPI assigned

Apr 20, 2006

Last updated

Dec 31, 2019By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bluegrass Orthopaedics PSCGroup PAC ID 4789988981, 62 clinicians

H2 Rehabilitation Services of Kentucky, LLCGroup PAC ID 5799682688, shared by 7 NPIs, 187 clinicians

PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rockcastle County Hospital, Inc. Hospital, Mount Vernon, KY, CCN 180115
• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Merit-based Incentive Payment System (MIPS)

Final score

18.32 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

61.06

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.61440

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.

• Bluegrass Orthopaedics PSC

  dba Bluegrass Orthopaedics

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1447622394
  Medicare reassignment Care Compare group
• Bluegrass Orthopaedics PSC

  • Durable Medical Equipment & Medical Supplies
  • Lexington, KY
  • NPI 1164922266
  NPD (past)
• Neurosurgical Associates PSC

  • Neurological Surgery Physician
  • Lexington, KY
  • NPI 1235110925
  NPD (past)

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

• Lake Cumberland Regional Hospital LLC

  dba Lake Cumberland Regional Hospital

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Rockcastle County Hospital, Inc.

  dba Rockcastle Regional Hospital and Respiratory Care Center

  • General Acute Care Hospital
  • Mount Vernon, KY
  • NPI 1104890714
  Care Compare affiliation

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1639134679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140",
            "fax_number": "859-263-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3480 YORKSHIRE MEDICAL PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091886",
            "telephone_number": "859-263-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "MICHAEL",
        "middle_name": "LOWELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA934",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA934",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95006094",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari June Blackburn, DNP, CPNP-PC
• Kelly Blackburn, RDN
• Kerigan Janae Blackburn
• Matthew Blackburn, PHARMD, BCCCP, BCPS
• Melissa J Blackburn, RPH
• Peter Blackburn, MD
• Rachel Ann Blackburn, M.ED., BCBA, LBA
• Rodney Buddy Blackburn, PHARMD
• Sarah Lee Ann Blackburn
• Sean M Blackburn, LCSW

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2019; 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.