Brent Blackburn, AG-ACNP - Medicare Nurse Practitioner in Stephens, AR

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Brent Blackburn, AG-ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Stephens, Arkansas. He graduated from nursing school in 2014 and has 10 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Johnathan Lewis Md Pllc and his current practice location is 113 West Ruby Street, Stephens, Arkansas. You can reach out to his office (for appointments etc.) via phone at (870) 786-9114.

Brent Blackburn is licensed to practice in Arkansas (license number A004186) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1548669823.

Contact Information

Brent Blackburn, AG-ACNP
113 West Ruby Street,
Stephens, AR 71764
(870) 786-9114
Not Available

Map and Direction




Provider's Profile

Full NameBrent Blackburn
GenderMale
SpecialityNurse Practitioner
Experience10 Years
Location113 West Ruby Street, Stephens, Arkansas
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Brent Blackburn graduated from nursing school in 2014
  NPI Data:
  • NPI Number: 1548669823
  • Provider Enumeration Date: 08/22/2014
  • Last Update Date: 08/22/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 2567684400
  • Enrollment ID: I20141110001953

Medical Identifiers

Medical identifiers for Brent Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548669823NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LA2100XNurse Practitioner - Acute Care A004186 (Arkansas)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Ouachita County Medical CenterCamden, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Johnathan Lewis Md Pllc26688917633

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Brent Blackburn allows following entities to bill medicare on his behalf.
Entity NameOuachita County Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1346354826
PECOS PAC ID: 4587641055
Enrollment ID: O20080813000469
Entity NameSouth Arkansas Emergency Physicians Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942435458
PECOS PAC ID: 4486705720
Enrollment ID: O20090629000005
Entity NameEss Of El Dorado, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861851131
PECOS PAC ID: 8325345432
Enrollment ID: O20160404001667
Entity NameJohnathan Lewis Md Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265047187
PECOS PAC ID: 2668891763
Enrollment ID: O20200923000480

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brent Blackburn is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Brent Blackburn, AG-ACNP
Po Box 797,
Camden, AR 71711-0797

Ph: (870) 836-1200		Brent Blackburn, AG-ACNP
113 West Ruby Street,
Stephens, AR 71764

Ph: (870) 786-9114

Reviews and Comments


Nurse Practitioner Nurses in Stephens, AR

Connie A Davis, APRN-BC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 113 W Ruby Street, Stephens, AR 71764
Phone: 870-786-9114    Fax: 870-786-5530
Kirstin Sue Williams, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 113 Ruby Street, Stephens, AR 71764
Phone: 870-786-9114    Fax: 870-786-5530

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.