Individual provider Active NPI

Blake Edward Averill, MD

  • Family Medicine Physician
  • Greenwood, IN
National Provider Identifier
1750819165
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01082209A Issued in IN
Practice address
1703 W Stones Crossing Rd Ste 100
Greenwood, IN 46143-8558
Phone
(317) 781-1133
Fax
(317) 837-4640
NPI assigned
May 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X 01082209A IN
Family Medicine Physician 207Q00000X 01082209A IN Primary

Addresses

Primary practice location

1703 W Stones Crossing Rd Ste 100
Greenwood, IN 46143-8558

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

5230 E Stop 11 Rd Ste 250
Indianapolis, IN 46237-6399
Phone (317) 528-8136

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address baverill246817@Direct.FranciscanAlliance.org Direct

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210720002440 IN Practitioner - Family Practice 9032487129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Louisville School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1703 W Stones Crossing Rd
Suite 100
Greenwood, IN 46143-8558
Phone (317) 528-8200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01082209AINMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Sep 15, 2021 Accepting new patients
Franciscan Physician Network Family Medicine CurrentSince Sep 15, 2021 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1703 W Stones Crossing Rd
Ste 100
Greenwood, IN 46143
Phone (317) 528-2141

1703 W Stones Crossing Rd
Ste 200
Greenwood, IN 46143
Phone (317) 781-7188

1703 W Stones Crossing Rd
Ste 210
Greenwood, IN 46143
Phone (317) 528-2270

5230 E Stop 11 Rd
Ste 250
Indianapolis, IN 46237
Phone (317) 528-8921

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: baverill246817@direct.franciscanalliance.org

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1496102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1750819165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 W STONES CROSSING RD STE 100",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461438558",
            "telephone_number": "317-781-1133",
            "fax_number": "317-837-4640"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5230 E Stop 11 Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462376399",
            "country_code": "US",
            "telephone_number": "317-528-8136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVERILL",
        "first_name": "BLAKE",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-30",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IN",
            "license": "01082209A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01082209A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "baverill246817@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1703 W Stones Crossing Rd Ste 200",
            "city": "Greenwood",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461438558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

Verify at the official NPI Registry.