TRISTAN DEE BLACKBURN (NPI# 1417176249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417176249 |
| Entity Type | Individual |
| Full Name | TRISTAN DEE BLACKBURN |
| Credential | M.D. |
| Practice Address |
3991 Dutchmans Ln Ste 300 Louisville KY 40207-4700 |
| Mailing Address |
Po Box 776351 Chicago IL 60677-6351 |
| Practice Telephone | 5028996061 |
| Practice Fax Number | 5028996127 |
| Mailing Telephone | 5025889490 |
| Mailing Fax Number | 5022725116 |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2016-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
46118 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | PASSPORT- NORTON RHEUMATOLOGY SPECIALISTS | 50052639 | 01 |
| IN | 201069110 | 05 | |
| KY | 7100252740 | 05 |
| Street Address |
3991 DUTCHMANS LN STE 300 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207-4700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962483602 | Manjari Motaparthi | Psychiatry & Neurology | 3991 Dutchmans Ln Ste 300, Louisville, KY 40207-4700 | 2005-11-09 |
| 1982193298 | Kristyn Lyn Clark | Nurse Practitioner | 3991 Dutchmans Ln Ste 300, Louisville, KY 40207 | 2018-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154769131 | Jacquelyn Smith | Internal Medicine | 3430 Newburg Rd Ste 250, Louisville, KY 40218-2458 | 2013-06-12 |
| 1063705432 | Archana Srinivas | Internal Medicine | 3991 Dutchmans Lane, Suite 300, Norton Rheumatology Associates, Louisville, KY 40207-0000 | 2011-05-18 |
| 1659400976 | Mark H Heinicke | Internal Medicine | 332 W Broadway Ste 217, Louisville, KY 40202-2114 | 2007-03-04 |
| 1023516028 | Community Medical Associates, Inc. | Internal Medicine | 1930 Bishop Ln Ste 1017, Louisville, KY 40218 | 2018-01-25 |
| 1699219477 | Joint Endeavors Pllc | Internal Medicine | 127 Fairfax Ave, Louisville, KY 40207-4905 | 2016-12-13 |
| 1447600622 | Lake Cumberland Rheumatology Pllc | Internal Medicine | 3901 Dutchmans Lane, Suite 202, Louisville, KY 40207-4727 | 2016-06-17 |
| 1407214414 | Community Medical Associates, Inc. | Internal Medicine | 1930 Bishop Ln, Suite 1017, Louisville, KY 40218 | 2016-02-04 |
| 1144595489 | University of Louisville Physicians, Inc | Internal Medicine | 401 E Chestnut St, Suite 310, Louisville, KY 40202-5700 | 2012-03-20 |
| 1477843308 | Ami Joglekar | Internal Medicine | 3991 Dutchmans Lane, Suite 300, Louisville, KY 40207-4723 | 2011-04-12 |
| 1780919407 | David H Neustadt Psc | Internal Medicine | 234 E Gray St, Suite 328, Louisville, KY 40202-1900 | 2009-10-14 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.