Charles Bartlett Blake, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

088073 Issued in MO

Practice address

208 N 36TH St
Nixa, MO 65714-7560

Phone

(417) 343-4202

Fax

(417) 869-1521

NPI assigned

Jul 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043224272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N 36TH ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147560",
            "telephone_number": "417-343-4202",
            "fax_number": "417-869-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N 36TH ST",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657147560",
            "telephone_number": "417-343-4202",
            "fax_number": "417-869-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "CHARLES",
        "middle_name": "BARTLETT",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "088073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Bennett
• Elizabeth Betebenner
• John Paul Billingsley, AGNP
• Leslie L Binder, MA, LMFT
• Julie Ann Blackford
• Nicole Blanchard, MS, CCC-SLP
• Aaron Blevins, PHARMD., R.PH.
• Blue Medical LLC
• Steven J Boling, PSYD, LPC
• Daniel Austin Boone, OD

• Registered Nurse in Nixa, MO
• Providers in Nixa, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.