Dustin Patrick Blackwell, DO

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

02005674A Issued in IN

Practice address

700 Willow St Ste 203
Vincennes, IN 47591-1029

Phone

(812) 882-1000

Fax

(812) 882-1004

NPI assigned

Feb 20, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Specialty

Obstetrics/Gynecology

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Hospital Physician Services, IncGroup PAC ID 3971671330, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042
• Crawford Memorial Hospital Hospital, Robinson, IL, CCN 141343

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblackwell211410@direct.deaconess.com

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.

• Good Samaritan Hospital Physician Services, Inc

  • Hospitalist Physician
  • Vincennes, IN
  • NPI 1649432071

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Good Samaritan Hospital

  • Rural Health Clinic/Center
  • Vincennes, IN
  • NPI 1760145973
  NPD
• Good Samaritan Hospital Physician Services Inc.

  • Radiation Oncology Physician
  • Vincennes, IN
  • NPI 1629050646
  NPD (past)

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

• Good Samaritan Hospital

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Vincennes, IN
  • NPI 1073153474

  Hospital

  Care Compare affiliation
• Good Samaritan Hospital

  • General Acute Care Hospital
  • Vincennes, IN
  • NPI 1225032881
  Care Compare affiliation
• Crawford Hospital District

  • Urology Physician
  • Newton, IL
  • NPI 1265309405

  Hospital

  Care Compare affiliation
• Crawford Hospital District

  • Critical Access Hospital
  • Robinson, IL
  • NPI 1265493720
  Care Compare affiliation

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1841682374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 E SAINT CLAIR ST.",
            "address_2": "NICHOLE ASH",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475914853",
            "telephone_number": "812-885-3106",
            "fax_number": "812-885-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 WILLOW ST STE 203",
            "city": "VINCENNES",
            "state": "IN",
            "postal_code": "475911029",
            "telephone_number": "812-882-1000",
            "fax_number": "812-882-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "DUSTIN",
        "middle_name": "PATRICK",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-20",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IN",
            "license": "02005674B",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IN",
            "license": "02005674A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300028633",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Lewis Bilskie Jr., PHD
• Bio-Medical Applications of Indiana, Inc.
• Angela Kay Black, MS, PT
• Brooke Christine Blackburn, LPTA
• Cindy Blackwell, PT
• Misty Blann, ASW
• Lisa Michelle Bloebaum, PHARMD
• Michelle Bloebaum
• Emily Jo Bobe, FNP-C
• Sally Bodensteiner, M.D.

• Obstetrics Physician in Vincennes, IN
• Providers in Vincennes, IN by specialty
• Obstetrics Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.