Gladys Blackburn, NP
Individual provider Active NPI Family Nurse Practitioner · Peru, IN
NPI 1861005589 · NPPES record last updated Feb 28, 2025
Key facts
- NPI
- 1861005589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71010379A (IN)
- Practice address
- 285 W 12TH St Ste 206
Peru, IN 46970-1654 - Phone
- (765) 472-5335
- NPI assigned
- Aug 24, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Indiana University School of Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Meridian Health Services Corp
Practice addresses (Care Compare)
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
285 W 12TH St
Peru, IN 46970-1654
Phone (765) 288-1928
911 N Western Ave
Marion, IN 46952-2505
Phone (765) 288-1928
Hospital & facility affiliations
- Dukes Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 90.99 of 100
- Quality
- 77.41
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201009002407 | IN | Practitioner - Nurse Practitioner | 0941620025 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28222639A | IN | MD | Registered Nurse |
| 71010379A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Health Services Corp | Current |
Accepting new patients | |
| Meridian Health Services Corp. | Current |
Accepting new patients |
Locations
240 N Tillotson Ave
Muncie, IN 47304
285 W 12th St
Ste 205
Peru, IN 46970
Phone (765) 472-5335
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 28222639A | IN | |
| Family Nurse Practitioner | 363LF0000X | 71010379A | IN | Yes |
Addresses
Primary practice location
285 W 12TH St Ste 206
Peru, IN 46970-1654
Mailing address
285 W 12TH St Ste 206
Peru, IN 46970-1654
Phone (765) 472-5335
Other practice location 1
1901 W Western Ave Ste B
South Bend, IN 46619-3570
Phone (574) 234-9033
Other names
- Gladys Alalade
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gladys.blackburn@lutheranhealthnetwork.cernerdirect.com | Direct |
Other providers in Peru, IN
- Robert N Becker
- Blaire Kirsten Bell
- Kimberly Michelle Bellar
- Marla Kay Berkshire
- Bio-Medical Applications of Indiana, Inc.
- Blair Emergency Physicians
- Maren Blevins
- Blue Sky Transportation, LLC
- Board of Trustees of Howard Community Hospital
- Kaylee Bohn
All providers in Peru, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.