Brent Blackburn, MD is a medicare enrolled "Family Medicine" in Texarkana, Arkansas. He graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Ouachita County Medical Center and his current practice location is
3417 U Of A Way, Texarkana, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 779-6000.
Brent Blackburn is licensed to practice in Arkansas (license number E19988) 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.
Provider's Profile
| Full Name | Brent Blackburn |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 2 Years |
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| Location | 3417 U Of A Way, Texarkana, Arkansas |
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| Accepts Medicare Assignments | Yes. 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 2024
NPI Data:
- NPI Number: 1548669823
- Provider Enumeration Date: 08/22/2014
- Last Update Date: 10/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 2567684400
- Enrollment ID: I20260303003526
Medical Identifiers
Medical identifiers for Brent Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1548669823 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LA2100X | Nurse Practitioner - Acute Care | A004186 (Arkansas) | Secondary |
| 207Q00000X | Family Medicine | E19988 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Ouachita County Medical Center | 4587641055 | 29 |
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 Name | Ouachita County Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346354826 PECOS PAC ID: 4587641055 Enrollment ID: O20080813000469 |
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| Entity Name | Ess of El Dorado, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861851131 PECOS PAC ID: 8325345432 Enrollment ID: O20160404001667 |
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| Entity Name | Hcc of El Dorado LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003578725 PECOS PAC ID: 1850789488 Enrollment ID: O20211101000418 |
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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 Address | Practice Location Address |
Brent Blackburn, MD 3417 U Of A Way, Texarkana, AR 71854-1419 Ph: (870) 779-6000 | Brent Blackburn, MD 3417 U Of A Way, Texarkana, AR 71854-1419 Ph: (870) 779-6000 |
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