KENDALL T BLAKE MD
NPI 1427072966
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Jackson, MS
About Kendall T Blake Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KENDALL T BLAKE MD (NPI 1427072966) is an individual orthopaedic surgery of the spine provider in Jackson, Mississippi, licensed in Mississippi (06797) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kendall T Blake Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kendall Blake reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Jackson, MS 39216
- Reassigned Medicare billing, Mississippi enrollment
- 1,932 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.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JACKSON, MS 39216
JACKSON, MS 39216
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 Kendall Blake's NPI number?
The NPI number for Kendall Blake is 1427072966. It was assigned to this individual provider in the NPPES registry on July 27, 2006.
Where is Kendall Blake located?
Kendall Blake practices at 2500 N State St Dept Of Orthopedics, Jackson, MS 39216. The listed phone number is (601) 984-6525.
What is Kendall Blake's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.
Is Kendall Blake enrolled in Medicare?
Yes. Kendall Blake is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Kendall Blake's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kendall Blake reassigns Medicare benefits to State Of Mississippi - University Of Mississippi Medical Center (Jackson, 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 Kendall Blake's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Kendall Blake was last updated on March 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Kendall T Blake, MD · NPI 1427072966
Orthopaedic Surgery of the Spine physician in Jackson, Mississippi. Individual provider, active in the CMS NPPES registry since July 27, 2006.
## Identity
- **NPI:** 1427072966 (Entity type: Individual)
- **Enumerated:** July 27, 2006
- **Primary specialty:** Orthopaedic Surgery - Orthopaedic Surgery of the Spine · taxonomy 207XS0117X
- **State license:** 06797 (Mississippi)
- **Sole proprietor:** No
## Practice location
- **Address:** 2500 N STATE ST, DEPT OF ORTHOPEDICS, Jackson, MS 39216-4500
- **Phone:** (601) 984-6525
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** State Of Mississippi - University Of Mississippi Medical Center (NPI 1154317527, Jackson, MS), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 7, 2014
- **Other identifiers:** Medicare PIN 332844YJ5D (MS); Medicaid 00116141 (MS); Medicare ID-Type Unspecified 200000389 (MS)
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Source: [NPI Profile](https://npiprofile.com/npi/1427072966) · Data from the CMS NPPES public registry.