CHARLES DEAN BLACKBURN (FNP-BC) – Family Nurse Practitioner, NPI 1821449679
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
7,017 NURSE PRACTITIONER in MO
Provider Addresses for CHARLES DEAN BLACKBURN (FNP-BC)
PO BOX 776084
CHICAGO, IL 606776084
Phone: (314) 364-7586
Type: Mailing
1001 CARDWELL ST
SAINT CLAIR, MO 630771094
Phone: (636) 629-3300
Fax: (636) 629-7377
Type: Location
800 W 9th St
Jasper, IN 475462514
Phone: (812) 996-2345
Type: Location
Memorial Hospital, 800, West 9th Street, Jasper, Dubois County, Indiana, 47546, United States
JASPER, IN 475462514
Phone:
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $151.
Total Amount is formed as General ($151) + Research ($0) + Ownership ($0) = $151.
Last reported payment date: 2024-12-20 • Largest payer in this snapshot: ABBVIE INC. ($38).
Total Amount
$151
General + Research + Ownership
Payments
8
Total payment records
General Amount
$151
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-20
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $38 |
| SANOFI-AVENTIS U.S. LLC | $27 |
| Novo Nordisk Inc | $20 |
| Mylan Specialty L.P. | $18 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $17 |
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: 2019-03-27
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190327002721 | I | Nurse Practitioner | MO | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,600 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 219 | 204 | $0 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 153 | 38 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 102 | 102 | $0 |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 93 | 90 | $0 |
Insurance plans in this area (ZIP 60677)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MO | |
| Internal Medicine | MO | |
| Nurse Practitioner | MO | |
| - | MO | |
| - | IL | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| Physical Medicine And Rehabilitation | MO | |
| - | MO | |
| Nurse Practitioner | MO |
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