Douglas Hunt Blackledge, D.O.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

23160 Issued in MS

Practice address

950 Matthew Dr
Waynesboro, MS 39367-2567

Phone

(601) 735-7246

Fax

(601) 735-7245

NPI assigned

Jul 12, 2010

Last updated

Mar 4, 2020By 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 MS, AL2 enrollments

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 2

Specialty

AnesthesiologyAlso: Emergency Medicine

Education

Edward Via Col of Osteo Medicine-Virginia Campus, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Meridian Anesthesiology Group, IncGroup PAC ID 1759345192, 23 clinicians

Medical Foundation IncGroup PAC ID 9234043712, 211 clinicians

Cullman Regional Pain Services LLCGroup PAC ID 1456694082, 16 clinicians

Cullman Regional Anesthesia Services LLCGroup PAC ID 2466785712, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Rush Hospital Hospital, Meridian, MS, CCN 250069
• Cullman Regional Medical Center Hospital, Cullman, AL, CCN 010035

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• Medical Foundation, Inc.

  • Family Medicine Physician
  • Meridian, MS
  • NPI 1609820539

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• Meridian Anesthesiology Group, Inc

  • Anesthesiology Physician
  • Meridian, MS
  • NPI 1639181019
  Medicare reassignment Care Compare group NPD
• Cullman Regional Anesthesia Services LLC

  • Anesthesiology Physician
  • Cullman, AL
  • NPI 1982163671
  Medicare reassignment Care Compare group NPD
• Cullman Regional Pain Services LLC

  • Anesthesiology Physician
  • Cullman, AL
  • NPI 1326507013
  Medicare reassignment Care Compare group NPD
• Medical Foundation, Inc.

  dba Ochsner Rush Medical Center Emergency Room Professional Services

  • Emergency Medicine Physician
  • Meridian, MS
  • NPI 1700917994
  NPD

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

• Rush Medical Foundation

  dba Ochsner Rush Medical Center

  • General Acute Care Hospital
  • Meridian, MS
  • NPI 1770543399
  Care Compare affiliation
• Cullman Regional Medical Center, Inc

  • General Acute Care Hospital
  • Cullman, AL
  • NPI 1114919339
  Care Compare affiliation

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

{
    "created_epoch": "1278892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1659683266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BRECKENRIDGE DR",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393673134",
            "telephone_number": "601-671-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MATTHEW DR",
            "city": "WAYNESBORO",
            "state": "MS",
            "postal_code": "393672567",
            "telephone_number": "601-735-7246",
            "fax_number": "601-735-7245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKLEDGE",
        "first_name": "DOUGLAS",
        "middle_name": "HUNT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-12",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "T-2288",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MS",
            "license": "23160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03504265",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Waynesboro, MS
• Providers in Waynesboro, MS by specialty
• Anesthesiology Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; 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.