Regina Blake

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN 092709 Issued in OH

Practice address

7757 Auburn Rd
Concord TWP, OH 44077-9609

Phone

(440) 350-2547

NPI assigned

Apr 20, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429488000000",
    "number": "1003203803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779609",
            "telephone_number": "440-350-2547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7757 AUBURN RD",
            "city": "CONCORD TWP",
            "state": "OH",
            "postal_code": "440779609",
            "telephone_number": "440-350-2547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "REGINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-20",
        "last_updated": "2015-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN 092709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Als LLC
• Karen Ann Alston, CNP
• Stephanie Marie Arnold, RN
• May Azem, MD
• Mark Jeffrey Barcelo, MD
• Joseph S. Borruso Jr., D.O.
• Jennifer L Botchick, MOT, OTR/L
• Marianne Brady
• Pamela Brunner
• Deborah Buckley

• Licensed Practical Nurse in Concord TWP, OH
• Providers in Concord TWP, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.