WILLIAM BLAKE MCKIBBIN M.D.
NPI 1295739878
Surgery in Fishersville, VA
About William Blake Mckibbin M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WILLIAM BLAKE MCKIBBIN M.D. (NPI 1295739878) is an individual surgery provider in Fishersville, Virginia, licensed in Virginia (0101240500) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Bolivar Medical Center, and is a graduate of Other (1999).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
William Blake Mckibbin M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show William Mckibbin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Cleveland, MS 38732
- Reassigned Medicare billing, Mississippi enrollment
- 42 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Bolivar Medical Center
Acute Care Hospitals · Cleveland, MSPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 22939 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES
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 William Mckibbin's NPI number?
The NPI number for William Mckibbin is 1295739878. It was assigned to this individual provider in the NPPES registry on June 10, 2005.
Where is William Mckibbin located?
William Mckibbin practices at 16 Ivy Ridge Ln Ste 130, Fishersville, VA 22939. The listed phone number is (540) 332-5909.
What is William Mckibbin's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is William Mckibbin enrolled in Medicare?
Yes. William Mckibbin is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for William Mckibbin's services?
According to the CMS Revalidation Reassignment List (October 2026 release), William Mckibbin reassigns Medicare benefits to Bolivar Physician Practices LLC (Cleveland, MS). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for William Mckibbin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does William Mckibbin accept?
Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter of Alabama and Ambetter of Tennessee and 3 other insurers list William Mckibbin 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.
Is William Mckibbin affiliated with any hospitals?
According to CMS data, William Mckibbin is affiliated with Bolivar Medical Center.
When was this NPI record last updated?
The NPPES record for William Mckibbin was last updated on February 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# William Blake Mckibbin, M.D. · NPI 1295739878
Surgery physician in Fishersville, Virginia. Individual provider, active in the CMS NPPES registry since June 10, 2005.
## Identity
- **NPI:** 1295739878 (Entity type: Individual)
- **Enumerated:** June 10, 2005
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 0101240500 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 16 IVY RIDGE LN STE 130, Fishersville, VA 22939-2354
- **Phone:** (540) 332-5909 · **Fax:** (540) 332-5910
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Bolivar Physician Practices LLC (NPI 1629379078, Cleveland, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1999
## Record status
- **NPPES last updated:** February 13, 2020
- **Other identifiers:** Medicaid 705155309A (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1295739878) · Data from the CMS NPPES public registry.