WILLIAM BLAKE MCKIBBIN (NPI# 1295739878) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295739878 |
| Entity Type | Individual |
| Full Name | WILLIAM BLAKE MCKIBBIN |
| Credential | M.D. |
| Practice Address |
16 Ivy Ridge Ln Ste 130 Fishersville VA 22939-2354 |
| Practice Telephone | 5403325909 |
| Practice Fax Number | 5403325910 |
| Mailing Telephone | 5403325909 |
| Mailing Fax Number | 5403325910 |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2020-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 052784 | GA | Allopathic & Osteopathic Physicians |
| Y | 208600000X | Surgery | 0101240500 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 705155309A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629025838 | William K Mckibbin | Orthopaedic Surgery | 305 Paul W Bryant Dr E, Tuscaloosa, AL 35401-2055 | 2006-05-31 |
| Street Address |
16 IVY RIDGE LN STE 130 |
| City | FISHERSVILLE |
| State | VA |
| Zip Code | 22939-2354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720190119 | Augusta Surgery Inc | Surgery | 16 Ivy Ridge Ln Ste 130, Fishersville, VA 22939-2354 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568956951 | Randy Groves | Physical Therapy Assistant | 84 Crossroads Lane, Fishersville, VA 22939 | 2018-06-19 |
| 1679081749 | Melissa Michelle Yniguez | Occupational Therapy Assistant | 83 Crossroad Lane, Fishersville, VA 22939 | 2018-01-11 |
| 1699126110 | Ashley Bigger | Physical Therapy Assistant | 83 Crossroad Ln, Fishersville, VA 22939 | 2016-06-27 |
| 1497146070 | Savola Aesthetic Dermatology Center Plc | Dermatology | 66 Parkway Lane, Suite 101, Fishersville, VA 22939 | 2015-02-18 |
| 1669813416 | Keith Harlow Wolford | Family Medicine | 1615 Jefferson Highway, Suite 108, Fishersville, VA 22939 | 2013-07-09 |
| 1588903041 | Ashanti Dawn Samuel | Student in an Organized Health Care Education/Training Program | 83 Crossroads Lane, Fishersville, VA 22939 | 2013-02-04 |
| 1588902399 | Janaki Pinakin Patel | Internal Medicine | 70 Medical Center Cir Ste 201, Fishersville, VA 22939 | 2013-01-29 |
| 1659699734 | Augusta Health Care, Inc | Internal Medicine | 221 Medical Center Circle, Fishersville, VA 22939 | 2010-05-13 |
| 1386979037 | Kyle J Becker | Pharmacist | 57 Beam Lane, Suite 300, Fishersville, VA 22939 | 2009-10-14 |
| 1275782526 | Augusta Medical Group | Family Medicine | 53 S Medical Park Drive, Fishersville, VA 22939 | 2008-09-11 |
| Find all providers in zip 22939 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871555995 | Leonardo Ramon Espinel Jr. | Surgery | 70 Medical Center Cir Ste 213, Fishersville, VA 22939-2273 | 2006-04-04 |
| 1225267347 | Timothy D Spencer | Surgery | 78 Medical Center Dr, Fishersville, VA 22939-2332 | 2009-07-10 |
| 1194929059 | Kristin C. Turza | Surgery | 70 Medical Center Cir, Suite 308, Fishersville, VA 22939-2273 | 2007-06-13 |
| 1700080249 | Mark Andres | Surgery | 70 Medical Center Cir Ste 213, Fishersville, VA 22939 | 2007-06-11 |
| 1487766002 | David Whitney Caulkins | Surgery | 78 Medical Center Dr, Fishersville, VA 22939-2332 | 2006-08-31 |
| 1720190119 | Augusta Surgery Inc | Surgery | 16 Ivy Ridge Ln Ste 130, Fishersville, VA 22939-2354 | 2006-08-31 |
| 1346258829 | William G. Thompson | Surgery | 70 Medical Center Cir, Suite 213, Fishersville, VA 22939 | 2006-08-03 |
| 1861406852 | Donald C. Carmichael | Surgery | 70 Medical Center Cir, Suite 213, Fishersville, VA 22939 | 2006-07-28 |
| 1336153428 | William L Faulkenberry II | Surgery | 70 Medical Center Cir, Suite 213, Fishersville, VA 22939-2273 | 2006-07-27 |
| 1699790147 | Joseph Lange Ranzini | Surgery | 78 Medical Center Dr, Fishersville, VA 22939-2332 | 2006-07-13 |
| Find all providers in FISHERSVILLE | ||||
| City | FISHERSVILLE |
| Zip Code | 22939 |
Please comment or provide details below to improve the information on WILLIAM BLAKE MCKIBBIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.