Individual provider Active NPI

Deborah Elaine Bliss, ACNP

  • Acute Care Nurse Practitioner
  • Edgewood, KY
National Provider Identifier
1013059559
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
COA.06835-NP Issued in OH
Practice address
1 Medical Village Drive
St. Elizabeth Healthcare
Edgewood, KY 41017-3403
Phone
(859) 301-2000
Fax
(859) 301-6900
NPI assigned
Feb 13, 2007
Last updated
Jan 15, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NP-3855P KY
Acute Care Nurse Practitioner 363LA2100X COA.06835-NP OH Primary

Addresses

Primary practice location

1 Medical Village Drive
St. Elizabeth Healthcare
Edgewood, KY 41017-3403

Mailing address

350 Thomas More Parkway
St. Elizabeth Healthcare, Suite 280
Crestview Hills, KY 41017
Phone (859) 426-0800

Other identifiers 1

IdentifierTypeStateIssuer
NP-06835OtherOHOHIO NP LICENSE

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

State licenses

LicenseStateTypeSpecialty
NP-3855PKYMDAcute Care Nurse Practitioner
COA.06835-NPOHMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1013059559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 THOMAS MORE PARKWAY",
            "address_2": "ST. ELIZABETH HEALTHCARE, SUITE 280",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-426-0800",
            "fax_number": "859-578-0222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL VILLAGE DRIVE",
            "address_2": "ST. ELIZABETH HEALTHCARE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173403",
            "telephone_number": "859-301-2000",
            "fax_number": "859-301-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLISS",
        "first_name": "DEBORAH",
        "middle_name": "ELAINE",
        "credential": "ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "NP-3855P",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "COA.06835-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO NP LICENSE",
            "identifier": "NP-06835",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.