LAURA ELIZABETH BLACKFORD (MD) – Family Medicine Physician, NPI 1073892428

LAURA ELIZABETH BLACKFORD (MD) is a healthcare provider. based in South bend, Indiana. specializing in FAMILY PRACTICE, OBSTETRICS/GYNECOLOGY. They hold the professional credentials MD. They hold a License No. 008-T1 (WY). The NPI Number for LAURA ELIZABETH BLACKFORD (MD) is 1073892428

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
LAURA ELIZABETH BLACKFORD (MD)
NPI
1073892428
Phone
(574) 335-8700
Address
PO BOX 6309
Enumeration Date
16 August 2011
Last Update Date
13 January 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5749485340
Graduation Year
2011 (15 years ago)
PAC ID
2567686819
Group Practice PAC ID
8325950843
Professional Enrollment ID
I20140917003050
Address ID
IN465637837PL2349XAVEX302
Telehealth
Yes

Contacts

Secure Messaging
laura.blackford@directsjpn.mhin.net
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness95
Years active:14State licenses:2Other names

2,866 FAMILY PRACTICE in IN

Provider Addresses for LAURA ELIZABETH BLACKFORD (MD)

  • PO BOX 6309

    SOUTH BEND, IN 466606309

    Phone: (574) 335-8700

    Fax: (574) 335-0760

    Type: Mailing

  • 5215 HOLY CROSS PKWY

    MISHAWAKA, IN 465451469

    Phone: (574) 335-8700

    Fax: (574) 335-0760

    Type: Mailing

  • 2349 LAKE AVE

    SUITE 100

    PLYMOUTH, IN 465637835

    Phone: (574) 948-5100

    Fax: (574) 948-5499

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-09-17

PECOS data refreshed: 2026-06-15

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
I20140917003050IFamily PracticeINTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes533282$0
99213Established patient office or other outpatient visit, 20-29 minutes222168$0
G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit175175$0
G0008Administration of influenza virus vaccine4241$0
90662Influenza vaccine split virus, preservative free4039$0
View full utilization report →

Insurance plans in this area (ZIP 46660)

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Provider's Procedures

LAURA ELIZABETH BLACKFORD (MD) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEIN81002Urinalysis, manual test3833

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: 8325950843View full group profile

Reviews

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Frequently asked questions

Is LAURA ELIZABETH BLACKFORD (MD) listed with a National Provider Identifier?
Yes — LAURA ELIZABETH BLACKFORD (MD) has NPI 1073892428 on file in the registry.
Is there an active status for LAURA ELIZABETH BLACKFORD (MD)?
For scheduling context, LAURA ELIZABETH BLACKFORD (MD) is shown as active in the registry.
What clinical focus is listed for LAURA ELIZABETH BLACKFORD (MD)?
At a glance, LAURA ELIZABETH BLACKFORD (MD) is tied to Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is LAURA ELIZABETH BLACKFORD (MD) located near South Bend?
LAURA ELIZABETH BLACKFORD (MD) currently maps to South Bend, Indiana in this extract.
Can I trust this NPI listing for LAURA ELIZABETH BLACKFORD (MD)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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