SCOTT ANTHONY BLACKBURN NP
NPI 1003554494
Nurse Practitioner - Primary Care in Southgate, MI
About Scott Anthony Blackburn Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SCOTT ANTHONY BLACKBURN NP (NPI 1003554494) is an individual primary care provider in Southgate, Michigan, licensed in Michigan (4704326782) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Scott Anthony Blackburn Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48195 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Scott Blackburn's NPI number?
The NPI number for Scott Blackburn is 1003554494. It was assigned to this individual provider in the NPPES registry on May 25, 2022.
Where is Scott Blackburn located?
Scott Blackburn practices at 11275 Allen Rd, Southgate, MI 48195. The listed phone number is (313) 383-7071.
What is Scott Blackburn's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.
Is Scott Blackburn enrolled in Medicare?
Yes. Scott Blackburn is registered in the Medicare PECOS enrollment system.
What insurance does Scott Blackburn accept?
Health plans from McLaren Health Plan Community and Priority Health list Scott Blackburn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Scott Blackburn was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Scott Anthony Blackburn, NP · NPI 1003554494
Primary Care physician in Southgate, Michigan. Individual provider, active in the CMS NPPES registry since May 25, 2022.
## Identity
- **NPI:** 1003554494 (Entity type: Individual)
- **Enumerated:** May 25, 2022
- **Primary specialty:** Nurse Practitioner - Primary Care · taxonomy 363LP2300X
- **State license:** 4704326782 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 11275 ALLEN RD, Southgate, MI 48195-3380
- **Phone:** (313) 383-7071 · **Fax:** (313) 383-7194
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** July 21, 2026
- **Other identifiers:** Other 4704326782 (MI)
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Source: [NPI Profile](https://npiprofile.com/npi/1003554494) · Data from the CMS NPPES public registry.