BLAKE D. WEATHERBY (CRNA) – Certified Registered Nurse Anesthetist, NPI 1235734542

BLAKE D. WEATHERBY (CRNA) is a healthcare provider. based in Lowell, Arkansas. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. 864477 (TX). The NPI Number for BLAKE D. WEATHERBY (CRNA) is 1235734542

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
BLAKE D. WEATHERBY (CRNA)
NPI
1235734542
Phone
(479) 338-8000
Address
PO BOX 507
Enumeration Date
3 December 2020
Last Update Date
1 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4798768111
Graduation Year
2020 (6 years ago)
PAC ID
9830504976
Group Practice PAC ID
2668914755
Professional Enrollment ID
I20210223000994
Address ID
AR727123104BE500XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:5State licenses:3Digital endpointsOther names

716 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in AR

Provider Addresses for BLAKE D. WEATHERBY (CRNA)

  • PO BOX 507

    LOWELL, AR 727450507

    Phone: (479) 338-8000

    Fax: (479) 338-3056

    Type: Mailing

  • 2710 S RIFE MEDICAL LN

    ROGERS, AR 727581452

    Phone: (479) 338-8000

    Fax: (479) 338-3056

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $47.

Total Amount is formed as General ($47) + Research ($0) + Ownership ($0) = $47.

Last reported payment date: 2024-01-31 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($47).

Total Amount

$47

General + Research + Ownership

Payments

2

Total payment records

General Amount

$47

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-31

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$47
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-02-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210223000994ICertified Registered Nurse Anesthetist (Crna)ARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00811Anesthesia for other procedure on large bowel using an endoscope2222$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1616$0
00812Anesthesia for exam of colon using an endoscope1313$0
View full utilization report →

Insurance plans in this area (ZIP 72745)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668914755View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR
Certified Registered Nurse Anesthetist (Crna)AR

Reviews

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Frequently asked questions

How do payers reference BLAKE D. WEATHERBY (CRNA)?
For BLAKE D. WEATHERBY (CRNA), use NPI 1235734542 as the unique 10-digit identifier.
Active or inactive — what applies to BLAKE D. WEATHERBY (CRNA)?
You should see BLAKE D. WEATHERBY (CRNA) as active in CMS-hosted NPPES data.
How would a patient describe BLAKE D. WEATHERBY (CRNA)'s focus?
For BLAKE D. WEATHERBY (CRNA), the primary taxonomy reads as Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Is BLAKE D. WEATHERBY (CRNA) located near Lowell?
BLAKE D. WEATHERBY (CRNA) currently maps to Lowell, Arkansas in this extract.
Does BLAKE D. WEATHERBY (CRNA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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