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

Ethan Wade Blackburn, MD

Individual provider Orthopaedic Surgery Physician · NPI 1538387360

Ethan Wade Blackburn, MD is an Orthopedic Surgery in Louisville, Kentucky. Graduated from University of Louisville School of Medicine in 2007, 19 years ago. Practices with Community Medical Associates Inc, a 1,365-clinician group. Licensed in Indiana and Kentucky.

Years since qualifying
19
Trained at
University of Louisville School of Medicine
Licensed in
IN, KY
In the registry since
2007
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

315 E Broadway Ste 195
Louisville, KY 40202-3700
Phone: (502) 629-4263
Fax: (502) 629-4282
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Hand Surgery Physician (primary) Taxonomy 207XS0106X · Licence 45826 (KY)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 45826 (KY)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence 01071401B (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1538387360
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 24, 2007
Last updated in NPPESJanuary 12, 2021
Certification dateJanuary 12, 2021

Medicare enrollment

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

Medicare specialtyORTHOPEDIC SURGERY
Medical schoolUNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Graduated 2007 (19 years in practice)
Group practice Community Medical Associates Inc — 1365 clinicians
Accepts Medicare assignment Not indicated
Practice locations6 on file with Medicare

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