DEBORRAH BLACKBURN
NPI 1710828322
Family Medicine in Saint Louis, MO

Q: What is Deborrah Blackburn's NPI number?

The NPI number for Deborrah Blackburn is 1710828322. It was assigned to this individual provider in the NPPES registry on April 6, 2026.

Q: What is Deborrah Blackburn's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since April 06, 2026PECOS Enrolled

12680 OLIVE BLVD STE 300, SAINT LOUIS, MO 63141(314) 251-8888 Get Directions Write a Review

NPPES record last updated: June 1, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2026, Apr 6, 2026 (2 updates tracked since 2026).

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About Deborrah Blackburn NPPES

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

DEBORRAH BLACKBURN (NPI 1710828322) is an individual family medicine provider in Saint Louis, Missouri, licensed in Missouri (2026021559) and active in the NPI registry since April 2026. She is enrolled in Medicare PECOS and maintains a secondary practice location in Saint Louis.

NPPES Registry Identity

NPI1710828322

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDEBORRAH BLACKBURN

Location Address12680 OLIVE BLVD STE 300Saint Louis, MO 63141-6322

Mailing Address12680 Olive Blvd Ste 300Saint Louis, MO 63141-6322 · (314) 251-8888

Phone(314) 251-8888

Sole ProprietorYes

Enumeration DateApril 6, 2026

Last NPPES UpdateJune 1, 20262 updates tracked since enumeration

NPPES CertifiedJune 1, 2026

✔ NPI 1710828322 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MO · 2026021559

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

12680 OLIVE BLVD STE 300, Saint Louis, MO 63141

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Secondary Practice Location 1

Location 1615 S New Ballas RdSaint Louis, MO 63141-8221 · Phone (314) 251-8888

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)

Deborrah Blackburn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 63141 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

$86.32 typical visit price

range $55.65 – $169.38

Typical copayment $21.58 (range $13.91 – $42.34)

Most-billed visit code 99203

Established Patient

$98.37 typical visit price

range $17.76 – $137.92

Typical copayment $24.59 (range $4.44 – $34.48)

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.

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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.

PRIYA SURESH KANNA MD

Family Medicine