WILLIAM BLAKE MCKIBBIN (M.D.) – Surgery Physician, NPI 1295739878

WILLIAM BLAKE MCKIBBIN (M.D.) is a healthcare provider. based in Fishersville, Virginia. specializing in GENERAL SURGERY. They hold the professional credentials M.D.. They hold a License No. 052784 (GA). The NPI Number for WILLIAM BLAKE MCKIBBIN (M.D.) is 1295739878

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
WILLIAM BLAKE MCKIBBIN (M.D.)
NPI
1295739878
Phone
(540) 332-5909
Address
16 IVY RIDGE LN STE 130
Enumeration Date
10 June 2005
Last Update Date
13 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6628433606
Graduation Year
1999 (27 years ago)
PAC ID
9032182969
Group Practice PAC ID
6305995895
Professional Enrollment ID
I20240820003652
Address ID
MS387322828CL810XXRDXX402
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

935 GENERAL SURGERY in VA

Provider Addresses for WILLIAM BLAKE MCKIBBIN (M.D.)

  • 16 IVY RIDGE LN STE 130

    FISHERSVILLE, VA 229392354

    Phone: (540) 332-5909

    Fax: (540) 332-5910

    Mailing address matches the actual address.

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: 2024-08-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20070131000532IGeneral SurgeryVATBD
I20240820003652IGeneral SurgeryMSTBD

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
99203New patient office or other outpatient visit, 30-44 minutes2424$0
99204New patient office or other outpatient visit, 45-59 minutes2121$0
99213Established patient office or other outpatient visit, 20-29 minutes1814$0
99214Established patient office or other outpatient visit, 30-39 minutes1715$0
View full utilization report →

Insurance plans in this area (ZIP 22939)

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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: 6305995895View full group profile
NameSpecialtyState
Internal MedicineTX
Internal MedicineMS
Nurse PractitionerMS
-MS
-MS
-MS
O B S T E T R I C S/ G Y N E C O L O G YMS
U R O L O G YMS
Thoracic SurgeryMI
Nurse PractitionerMS

Reviews

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Frequently asked questions

What is the 10-digit NPI for WILLIAM BLAKE MCKIBBIN (M.D.)?
WILLIAM BLAKE MCKIBBIN (M.D.) — NPI 1295739878 — is the standard way to identify this listing.
Can I rely on WILLIAM BLAKE MCKIBBIN (M.D.) being an active provider?
As of the registry snapshot, WILLIAM BLAKE MCKIBBIN (M.D.) is marked active.
What is WILLIAM BLAKE MCKIBBIN (M.D.) best known for clinically?
Directory data describes WILLIAM BLAKE MCKIBBIN (M.D.) with Surgery Physician. Clinical services aligned with this taxonomy classification.
Does WILLIAM BLAKE MCKIBBIN (M.D.) list a practice location?
Patients near Fishersville, Virginia may find WILLIAM BLAKE MCKIBBIN (M.D.) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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