Active NPI
Blake Harrison Priddy, M.D.
- Family Medicine Physician
- Indianapolis, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 11019795A
- Practice address
- 355 W 16TH St Ste 5100
Indianapolis, IN 46202-2274 - Phone
- (317) 396-1234
- NPI assigned
- May 14, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 11019795A | IN | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | 11019795A | IN |
Addresses
Primary practice location
355 W 16TH St Ste 5100
Indianapolis, IN 46202-2274
Mailing address
355 W 16TH St Ste 5100
Indianapolis, IN 46202-2274
Phone (317) 396-1234
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
118 Medical Dr
Carmel, IN 46032-3323
Phone (877) 866-7123
120 E Miller Dr
Bloomington, IN 47401-6538
Phone (877) 866-7123
140 W Washington St
Morgantown, IN 46160-9547
Phone (317) 597-4418
1701 McDowell Rd
Evansville, IN 47712-5431
Phone (877) 866-7123
2741 N Salisbury St
West Lafayette, IN 47906-1431
Phone (877) 866-7123
3401 Soldiers Home Rd
West Lafayette, IN 47906-1222
Phone (877) 866-7123
5430 W US Hwy 40
Greenfield, IN 46140-8803
Phone (877) 866-7123
725 N Bell Trace Cir
Bloomington, IN 47408-4408
Phone (877) 866-7123
8616 W 10TH St
Indianapolis, IN 46234-2167
Phone (877) 866-7123
868 S Washington St
Morristown, IN 46161-9633
Phone (877) 866-7123
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 414 |
| Removal of skin lesions | 19 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11019795A | IN | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vohra Wound Physicians of the West, P.C. | Family Medicine | Current | Accepting new patients |
| Major Hospital | Past | Accepting new patients |
Locations
3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951
9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Shelbyville, IN
- NPI 1174555692
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Noblesville, IN
- NPI 1700883717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526256000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622592000000",
"number": "1699265892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 W 16TH ST STE 5100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022274",
"telephone_number": "317-396-1234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 W 16TH ST STE 5100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462022274",
"telephone_number": "317-396-1234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRIDDY",
"first_name": "BLAKE",
"middle_name": "HARRISON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-14",
"last_updated": "2021-06-02",
"certification_date": "2021-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IN",
"license": "11019795A",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "11019795A",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.