Active NPI
Medra M Blevins
- Critical Care Neonatal Nurse Practitioner
- Dallas, TX
National Provider Identifier
1043972789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Neonatal Nurse Practitioner
- License
- 1034154
- Practice address
- 6201 Harry Hines Blvd
Dallas, TX 75390-9134 - Phone
- (214) 633-6591
- NPI assigned
- Oct 11, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | 1034154 | TX | Primary |
Addresses
Primary practice location
6201 Harry Hines Blvd
Dallas, TX 75390-9134
Mailing address
6201 Harry Hines Blvd
Dallas, TX 75390-9134
Phone (214) 633-6591
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1043972789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6201 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753909134",
"telephone_number": "214-633-6591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 HARRY HINES BLVD",
"city": "DALLAS",
"state": "TX",
"postal_code": "753909134",
"telephone_number": "214-633-6591"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEVINS",
"first_name": "MEDRA",
"middle_name": "M",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-11",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "TX",
"license": "1034154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.