Gladys Blackburn, NP in Peru, IN - Medicare Nurse Practitioner

Gladys Blackburn, NP is a medicare enrolled "Nurse Practitioner - Family" in Peru, Indiana. Her current practice location is 285 W 12th St Ste 206, Peru, Indiana. You can reach out to her office (for appointments etc.) via phone at (765) 472-5335.

Gladys Blackburn is licensed to practice in Indiana (license number 71010379A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1861005589.

Contact Information

	Gladys Blackburn, NP
	285 W 12th St Ste 206, Peru, IN 46970-1654
	(765) 472-5335
	Not Available

Map and Direction

Provider's Profile

Full Name	Gladys Blackburn
Gender	Female
Speciality	Nurse Practitioner - Family
Location	285 W 12th St Ste 206, Peru, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861005589
Provider Enumeration Date: 08/24/2020
Last Update Date: 02/28/2025

Medicare PECOS Information:

PECOS PAC ID: 0941620025
Enrollment ID: I20201009002407

Medical Identifiers

Medical identifiers for Gladys Blackburn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861005589	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	28222639A (Indiana)	Secondary
363LF0000X	Nurse Practitioner - Family	71010379A (Indiana)	Primary

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. Gladys Blackburn allows following entities to bill medicare on her behalf.

Entity Name	Meridian Health Services Corp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1992755490 PECOS PAC ID: 5597679845 Enrollment ID: O20031119000531

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. Gladys 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
Gladys Blackburn, NP 285 W 12th St Ste 206, Peru, IN 46970-1654 Ph: (765) 472-5335	Gladys Blackburn, NP 285 W 12th St Ste 206, Peru, IN 46970-1654 Ph: (765) 472-5335

Reviews and Comments

Nurse Practitioner Nurses in Peru, IN

Phyllis Annette Ingham, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 750 N Broadway, Peru, IN 46970 Phone: 260-569-2120 Fax: 260-569-2121
Heather Weber, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 315 W Old Key Dr, Peru, IN 46970 Phone: 765-475-6963 Fax: 765-475-2833
Elaine Olson, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 315 W Old Key Dr Ste 150, Peru, IN 46970 Phone: 765-430-7507 Fax: 765-475-2839
Jay Lee Hoeksema, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 661 E Main St, Peru, IN 46970 Phone: 765-472-2519 Fax: 765-400-4465
Joanna Leigh Moore, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 661 E Main St, Peru, IN 46970 Phone: 765-472-2519 Fax: 765-400-4465
Katina A Everding, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2484 S Business 31, Suite C, Peru, IN 46970 Phone: 765-472-2722 Fax: 765-472-2722
Monica Lynn Mcmain, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1694 W Logansport Rd, Peru, IN 46970 Phone: 765-472-2519

Gladys Blackburn, NP - Medicare Nurse Practitioner in Peru, IN