DR. MICHAEL C BLAKLEY MD NPI 1184607038

NPI Information

NPI: 1184607038
Provider Name: DR. MICHAEL C BLAKLEY, MD
Classification: Pediatrics - 2080P0216X
Entity Type: Individual

Specialization: Pediatric Rheumatology

PECOS Registration: Yes

Address:
705 RILEY HOSPITAL DR
RR 307
INDIANAPOLIS, IN
ZIP 46202
Phone: (317) 274-2172
Get Directions

DR. Michael C Blakley, MD is a pediatric rheumatology pediatrics in Indianapolis, IN with 23 years of experience. The provider is a pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases. DR. Michael C Blakley, MD NPI is 1184607038. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Graduation Year:2001

The provider's business location address is:

705 RILEY HOSPITAL DR
RR 307
INDIANAPOLIS, IN
ZIP 46202-109
Phone: (317) 274-2172
Fax: (317) 278-3031

The NPI 1184607038 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/23/2005 and was last updated on 12/15/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		01060351A	INDIANA	No
2	207RR0500X	Internal Medicine	Rheumatology	01060351A	INDIANA	No
3	208000000X	Pediatrics		01060351A	INDIANA	No
4	2080P0216X	Pediatrics	Pediatric Rheumatology	01060351A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	200903650	MEDICAID	INDIANA
2	P01339696	OTHER	INDIANA	RAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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