Blair Brockman, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3009743 Issued in KY

Practice address

2601 Kentucky Ave
Suite 301
Paducah, KY 42003-3817

Phone

(270) 575-3113

Fax

(270) 575-3135

NPI assigned

Sep 15, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Paducah Hospital, Paducah, KY, CCN 180104

Merit-based Incentive Payment System (MIPS)

Final score

94.29 of 100Reported as apm

Quality

87.32

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  Medicare reassignment NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1184119398
  NPD
• Baptist Health Medical Group Inc

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1780961300
  NPD (past)

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

• Baptist Healthcare System, Inc

  • General Acute Care Hospital
  • Paducah, KY
  • NPI 1730264128
  Care Compare affiliation

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607385600000",
    "number": "1891164349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 KENTUCKY AVE",
            "address_2": "SUITE 306",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033800",
            "telephone_number": "270-415-7653",
            "fax_number": "270-575-8359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 KENTUCKY AVE",
            "address_2": "SUITE 301",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033817",
            "telephone_number": "270-575-3113",
            "fax_number": "270-575-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKMAN",
        "first_name": "BLAIR",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100370180",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbrockman13083@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2601 Kentucky Ave",
            "address_2": "Suite 301",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420033817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ron Brisbon Sr.
• Broadway Church of Christ
• Broadway Dental Care
• Broadway Dental Care, PLLC
• Nathan Brockett
• Shelly Ray Brockman, APRN
• Ashlee Brockwell, LPP
• Bryar Jeannine Brooks, DMD
• Hannah Kathryn Brooks, LCSW
• Renda L Brooks

• Family Nurse Practitioner in Paducah, KY
• Providers in Paducah, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.