NPIMap

Individual provider Active NPI

Michael Vaughn Baxter Bledsoe, D.O.

  • Family Medicine Physician
  • Ronceverte, WV
National Provider Identifier
1770979874
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3097 Issued in WV
Practice address
1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone
(304) 647-4411
NPI assigned
Apr 15, 2015
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3097 WV Primary

Addresses

Primary practice location

1320 Maplewood Ave
Ronceverte, WV 24970-8016

Mailing address

1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone (304) 647-4411

Other practice location 1

701 Madison Ave
Madison, WV 25130-1669
Phone (304) 369-1230

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.bledsoe@camc.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180905001337 WV Practitioner - Family Practice 7810203163 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Oak Hill Emergency Physicians, LLCGroup PAC ID 8123292950, 9 clinicians

Practice addresses (Care Compare)

1320 Maplewood Ave
Ronceverte, WV 24970-8016
Phone (304) 647-4411

430 Main St W
Oak Hill, WV 25901-3414
Phone (304) 647-4411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
309WVMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center, Inc. Current Accepting new patients
Boone Memorial Hospital, Inc CurrentSince May 26, 2019 Accepting new patients
Boone Memorial Hospital, Inc Family Medicine CurrentSince May 26, 2019 Accepting new patients
Camc Greenbrier Valley Medical Center Inc Family Medicine CurrentSince Nov 1, 2023 Accepting new patients
Charleston Area Medical Center Inc CurrentSince Apr 16, 2024 Accepting new patients
Camc Greenbrier Valley Medical Center, Inc. CurrentSince Nov 1, 2023 Accepting new patients
Boone Memorial Hospital, Inc Current Accepting new patients
Boone Memorial Hospital, Inc Family Medicine Current Accepting new patients
Oak Hill Emergency Physicians, LLC CurrentSince Dec 1, 2024 Accepting new patients
Charleston Area Medical Center, Inc. CurrentSince Apr 16, 2024 Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients
Boone Memorial Hospital, Inc Past Accepting new patients

Locations

400 Association Dr
Ste 102
Charleston, WV 25311
Phone (304) 388-1762

6952 Coal River Rd
#C
Comfort, WV 25049
Phone (304) 307-3116

300 4th St
Danville, WV 25053
Phone (304) 307-6201

660 S Main St
#A
Madison, WV 25130
Phone (304) 369-1230

701 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

716 Madison Ave
Madison, WV 25130
Phone (304) 369-1230

430 Main St W
Oak Hill, WV 25901
Phone (276) 325-0678

1320 Maplewood Ave
Ronceverte, WV 24970
Phone (304) 645-0870

1521 Maplewood Ave
Ronceverte, WV 24970

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/boonemh-81155461

Organizations & group practices 13

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.

View all 13

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1770979874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "304-647-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MAPLEWOOD AVE",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708016",
            "telephone_number": "304-647-4411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WV",
            "postal_code": "251301669",
            "country_code": "US",
            "telephone_number": "304-369-1230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "MICHAEL",
        "middle_name": "VAUGHN BAXTER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "3097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.bledsoe@camc.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1320 Maplewood Ave",
            "city": "Ronceverte",
            "state": "WV",
            "country_code": "US",
            "postal_code": "249708016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ronceverte, WV

Sources for this page

Verify at the official NPI Registry.