Kaylynn Rae Blackstad, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

245 Fountain CT Ste 225
Lexington, KY 40509-2794

Phone

(859) 323-6861

NPI assigned

Mar 28, 2024

Last updated

Mar 28, 2024By the provider in NPPES

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 names 1

• Kaylynn Rae Wilkes Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Kentucky Medical Services Foundation, Inc

  • Internal Medicine Physician
  • Lexington, KY
  • NPI 1326091448
  NPD (past)

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1952152035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT STE 225",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092794",
            "telephone_number": "859-323-6861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 FOUNTAIN CT STE 225",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092794",
            "telephone_number": "859-323-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKSTAD",
        "first_name": "KAYLYNN",
        "middle_name": "RAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLYNN",
            "last_name": "WILKES",
            "middle_name": "RAE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Yuliya Mikhaylovna Blackburn, PHARM D
• Audrey Nicole Blacketer, CF
• Camille Francoise Michelle Blackman, MD
• Chelsea Blackman, LPCA
• Emily Madden Duncan Blackman, CRNA
• Helen Blackstone
• Jessica Blain, APRN
• Crystal Jhan Blaine
• Abigail Jordyn Blair, BSN, RN
• Alison Blair, LMT

• Student in an Organized Health Care Education/Training Program in Lexington, KY
• Providers in Lexington, KY by specialty
• Student in an Organized Health Care Education/Training Program in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.