NPIMap

Individual provider Active NPI

Blake Jordan Grider, M.D.

  • Emergency Medicine Physician
  • Indianapolis, IN
National Provider Identifier
1891089538
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
01073655A Issued in IN
Practice address
2001 W 86TH St
Indianapolis, IN 46260
Phone
(317) 338-2345
NPI assigned
May 29, 2011
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01073655A IN Primary
Emergency Medicine Physician 207P00000X 35.154600 OH
Emergency Medicine Physician 207P00000X ME180410 FL

Addresses

Primary practice location

2001 W 86TH St
Indianapolis, IN 46260

Mailing address

4420 N Pennsylvania St
Indianapolis, IN 46205-1728
Phone (317) 925-1467

Other practice location 1

169 Ashley Ave
Room 202 Main Hospital MSC 333
Charleston, SC 29425-8905
Phone (843) 876-8023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, OH, FL3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20140514002239 IN Practitioner - Emergency Medicine 9931322211 Reassigns benefits to 1 organization
I20251203003846 OH Practitioner - Emergency Medicine 9931322211 Reassigns benefits to 2 organizations
I20260421003586 FL Practitioner - Emergency Medicine 9931322211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

500 London Ave
Marysville, OH 43040-3570
Phone (937) 644-6115

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME180410FLMDEmergency Medicine Physician
01073655AINMDEmergency Medicine Physician
35.154600OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital of Union County CurrentSince Apr 15, 2026 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients
Memorial Hospital of Union County CurrentSince Apr 15, 2026 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Dec 8, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2022 Accepting new patients
Major Hospital Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1206 E National Ave
Brazil, IN 47834
Phone (812) 442-2480

13861 Olio Rd
Fishers, IN 46037
Phone (317) 338-7136

801 N State St
Greenfield, IN 46140
Phone (317) 462-5544

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

1300 N Main St
Rushville, IN 46173
Phone (317) 802-3106

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

11850 Sycamore Trce
Ste A
Plain City, OH 43064
Phone (614) 881-3473

Organizations & group practices 8

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 6

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": "1306627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1891089538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 N PENNSYLVANIA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051728",
            "telephone_number": "317-925-1467",
            "fax_number": "317-925-9850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46260",
            "telephone_number": "317-338-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 Ashley Ave",
            "address_2": "Room 202 Main Hospital MSC 333",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294258905",
            "country_code": "US",
            "telephone_number": "843-876-8023",
            "fax_number": "843-792-9616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIDER",
        "first_name": "BLAKE",
        "middle_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-29",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01073655A",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.154600",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME180410",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.