Active NPI
Robert Clancy Blue
- Psychiatric/Mental Health Registered Nurse
- Weston, MA
National Provider Identifier
1023853348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Registered Nurse
- License
- 1078800
- Practice address
- 235 Wellesley St Ste 1
Weston, MA 02493-1571 - Phone
- (781) 768-7000
- NPI assigned
- Jun 27, 2024
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 1078800 | TX | Primary |
Addresses
Primary practice location
235 Wellesley St Ste 1
Weston, MA 02493-1571
Mailing address
6113 Monticello Dr
Frisco, TX 75035-8396
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1078800 | TX | MD | Psychiatric/Mental Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1023853348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6113 MONTICELLO DR",
"city": "FRISCO",
"state": "TX",
"postal_code": "750358396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 WELLESLEY ST STE 1",
"city": "WESTON",
"state": "MA",
"postal_code": "024931571",
"telephone_number": "781-768-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "ROBERT",
"middle_name": "CLANCY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-27",
"last_updated": "2024-06-27",
"certification_date": "2024-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": "TX",
"license": "1078800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Weston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.