Carolyn Ann Blackburn, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2017032960 Issued in MO

Practice address

245 S Washington St
Chillicothe, MO 64601-3031

Phone

(660) 752-9006

Fax

(660) 258-9006

NPI assigned

Jun 18, 2017

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Cari Blackburn Other name

Medicare fee-for-service enrollment

Enrolled in MO

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hannibal Regional Healthcare System IncGroup PAC ID 1254236300, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hedrick Medical Center Hospital, Chillicothe, MO, CCN 261321
• Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carolyn.blackburn.p1@direct.cfmkv.nextgenshare.com
• FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

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.

• Hannibal Regional Healthcare System, Inc

  dba Hannibal Regional Medical Group

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  Medicare reassignment Care Compare group NPD
• Scotland County Memorial Hospital

  dba Scotland County Hospital

  • Critical Access Hospital
  • Memphis, MO
  • NPI 1083624647
  Medicare reassignment NPD
• Hannibal Regional Healthcare System Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1003956095
  NPD
• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Kirksville, MO
  • NPI 1447789300
  NPD

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

• Hannibal Regional Healthcare System, Inc

  • Rural Acute Care Hospital
  • Hannibal, MO
  • NPI 1922042704
  Care Compare affiliation
• Saint Lukes Hospital of Chillicothe

  dba Hedrick Medical Center

  • Critical Access Hospital
  • Chillicothe, MO
  • NPI 1912948308
  Care Compare affiliation

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1902336431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 S WASHINGTON ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013031",
            "telephone_number": "660-751-9006",
            "fax_number": "660-258-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 S WASHINGTON ST",
            "city": "CHILLICOTHE",
            "state": "MO",
            "postal_code": "646013031",
            "telephone_number": "660-752-9006",
            "fax_number": "660-258-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017032960",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2008017992",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420047801",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARI",
            "last_name": "BLACKBURN",
            "credential": "FNP-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Bella-Brooke, LLC
• Eric David Berghoff, PHARMD
• Audra Dee Bergquist, DDS
• Amy Lynn Berry, PHARMD
• Better Way, LLC
• William E Brade, C.R.N.A.
• Roger O Brick, DC
• Bristol Care, Inc.
• Bruce L Brodmerkle, O.D.
• Margaret K. Brookshier, L.P.C.

• Family Nurse Practitioner in Chillicothe, MO
• Providers in Chillicothe, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.