Active NPI
Joy Blakeslee, MA, WSC
- Developmental Disabilities Clinic/Center
- Port Saint Lucie, FL
National Provider Identifier
1003322132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Disabilities Clinic/Center
- Practice address
- 3100 Columbrina Cir
Port Saint Lucie, FL 34952-3334 - Phone
- (772) 212-5695
- Fax
- (772) 361-6350
- NPI assigned
- Dec 27, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Disabilities Clinic/Center | 261QD1600X | FL | Primary |
Addresses
Primary practice location
3100 Columbrina Cir
Port Saint Lucie, FL 34952-3334
Mailing address
3100 Columbrina Cir
Port Saint Lucie, FL 34952-3334
Phone (772) 212-5695
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 021924900 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1514332800000",
"number": "1003322132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 COLUMBRINA CIR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349523334",
"telephone_number": "772-212-5695",
"fax_number": "772-361-6350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 COLUMBRINA CIR",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349523334",
"telephone_number": "772-212-5695",
"fax_number": "772-361-6350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKESLEE",
"first_name": "JOY",
"credential": "MA, WSC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-12-27",
"last_updated": "2017-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "261QD1600X",
"taxonomy_group": "",
"desc": "Clinic/Center, Developmental Disabilities",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "021924900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.