Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Dean Blackburn, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1821449679

Charles Dean Blackburn, FNP-BC is a Nurse Practitioner in Saint Clair, Missouri. Qualified in 2015, 11 years ago. Practices with Mercy Clinic East Communities, a 573-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Missouri.

Years since qualifying
11
Licensed in
IN, MO
In the registry since
2016
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1001 Cardwell St
Saint Clair, MO 63077-1094
Phone: (636) 629-3300
Fax: (636) 629-7377
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 800 W 9th St, Jasper, IN 47546-2514 — (812) 996-2345

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71006846A (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2016019132 (MO)

Record details

NPI number1821449679
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-BC
Sole proprietorYes
NPI enumeratedJune 23, 2016
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 25, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Mercy Clinic East Communities — 573 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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