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WILLIAM BLAKE PMHNP-BC
NPI 1093683385
Nurse Practitioner - Psychiatric/Mental Health in Bardstown, KY

Active since October 28, 2025PECOS Enrolled
110 E OBRYAN AVE, BARDSTOWN, KY 40004(502) 890-9232 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About William Blake Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLIAM BLAKE PMHNP-BC (NPI 1093683385) is an individual psychiatric/mental health provider in Bardstown, Kentucky, licensed in Kentucky (4047867) and active in the NPI registry since October 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Louisville, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1093683385
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameWILLIAM BLAKECredential: PMHNP-BC
Location Address110 E OBRYAN AVEBardstown, KY 40004-1636
Mailing Address7816 Hepatica DrLouisville, KY 40258-2272 · (502) 225-3299
Phone(502) 890-9232
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 28, 2025
Last NPPES UpdateMarch 27, 2026
NPPES CertifiedMarch 27, 2026
✔ NPI 1093683385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in KY · 4047867
110 E OBRYAN AVE, Bardstown, KY 40004
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Secondary Practice Location 1

Location 12020 Newburg RdLouisville, KY 40205-1803 · Phone (502) 451-3330

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

William Blake Pmhnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1850871641
PECOS Enrollment IDI20260219002364
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40004 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LR COUNSELING SERVICES LLC
Marriage & Family Therapist
110 E OBRYAN AVE
BARDSTOWN, KY 40004
Nelson County (502) 641-1301

Frequently Asked Questions

What is William Blake's NPI number?

The NPI number assigned to this healthcare provider is 1093683385, enumerated as an "individual" on October 28, 2025.

Where is the provider located?

The provider is located at 110 E OBRYAN AVE BARDSTOWN, KY 40004 and the phone number is (502) 890-9232.

What is the provider's specialty?

Nurse Practitioner with taxonomy code 363LP0808X and a focus in Psychiatric/Mental Health.