NPIMap

Individual provider Active NPI

William A. Blume, MD

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1952392490
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01030705 Issued in IN
Practice address
4501 N 4TH Ave
Evansville, IN 47710-3529
Phone
(812) 422-7212
Fax
(812) 422-7326
NPI assigned
Nov 3, 2005
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01030705 IN Primary

Addresses

Primary practice location

4501 N 4TH Ave
Evansville, IN 47710-3529

Mailing address

4501 N 4TH Ave
Evansville, IN 47710-3529
Phone (812) 422-7212

Other identifiers 1

IdentifierTypeStateIssuer
100247160AMedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100224000113 IN Practitioner - Family Practice 3375687783 Receives reassigned benefits from 3 practitioners
Practice locations: Evansville, IN

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Indiana University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Easter Seals Rehabilitation Center IncGroup PAC ID 8426135179, shared by 3 NPIs, 41 clinicians

Practice addresses (Care Compare)

3701 Bellemeade Ave
Evansville, IN 47714-0137
Phone (812) 479-1411

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01030705INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
William a. Blume, MD Family Medicine CurrentSince May 16, 2021 Accepting new patients

Locations

4501 N 4th Ave
Evansville, IN 47710
Phone (812) 422-7212

4501 N 4th Ave
#A
Evansville, IN 47710
Phone (812) 422-7212

Interoperability endpoints

  • Direct secure messaging: wblume25452@direct.deaconess.com

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Organizations & group practices 1

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 12

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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1952392490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 N 4TH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103529",
            "telephone_number": "812-422-7212",
            "fax_number": "812-422-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 N 4TH AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477103529",
            "telephone_number": "812-422-7212",
            "fax_number": "812-422-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUME",
        "first_name": "WILLIAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01030705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100247160A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.