Active NPI
Jacob Colman Blakeman, DPM
- Foot & Ankle Surgery Podiatrist
- Leesville, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 300191
- Practice address
- 506 S 6TH St
Leesville, LA 71446-4482 - Phone
- (337) 239-0989
- Fax
- (337) 239-0987
- NPI assigned
- Apr 20, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 300191 | LA | Primary |
Addresses
Primary practice location
506 S 6TH St
Leesville, LA 71446-4482
Mailing address
172 Lonesome Hill Rd
Leesville, LA 71446-6231
Phone (217) 717-7836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Other, 2012
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
3908 Maryville Rd
Suite 4
Granite City, IL 62040-4197
Phone (618) 931-3338
Hospital & facility affiliations
- Gateway Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.11 of 100
- Quality
- 51.58
- Promoting interoperability
- 98
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 53 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 16 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Il Medical Group LLC | Current | Accepting new patients | |
| Granite City Physicians Corp | Past | Accepting new patients |
Locations
1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870
12 Ginger Creek Pkwy
Glen Carbon, IL 62034
Phone (618) 656-8200
4802 S State Route 159
Glen Carbon, IL 62034
Phone 61828843883331
2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000
2044 Madison Ave
Ste 25
Granite City, IL 62040
Phone (618) 239-0678
3908 Maryville Rd
Ste 4
Granite City, IL 62040
Phone (618) 288-6870
2100 Madison Ave
Ste 201
Granite City, IL 62040
Phone (618) 798-8400
2044 Madison Ave
Ste 27
Granite City, IL 62040
Phone (618) 451-0700
2100 Madison Ave
Ste 301
Granite City, IL 62040
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
Interoperability endpoints
- jcblakem@yourcarecommunity.org
- jacob.blakeman.1@28328.direct.athenahealth.com
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.
-
- Clinic/Center
- Granite City, IL
- NPI 1659098101
-
- Clinical Medical Laboratory
- Granite City, IL
- NPI 1508983214
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Granite City, IL
- NPI 1326765884
-
- Urgent Care Clinic/Center
- Glen Carbon, IL
- NPI 1700586344
Hospital
-
- Urgent Care Clinic/Center
- Columbia, IL
- NPI 1982304523
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449446400000",
"number": "1760749261",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 LONESOME HILL RD",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714466231",
"telephone_number": "217-717-7836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "506 S 6TH ST",
"city": "LEESVILLE",
"state": "LA",
"postal_code": "714464482",
"telephone_number": "337-239-0989",
"fax_number": "337-239-0987"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKEMAN",
"first_name": "JACOB",
"middle_name": "COLMAN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-04-20",
"last_updated": "2015-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "LA",
"license": "300191",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Leesville, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; 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.