Lisa Ann Blum

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1084712 Issued in TX

Practice address

6913 N 40TH St
McAllen, TX 78504-5400

Phone

(956) 534-1471

NPI assigned

Jul 29, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• DHC Divine Health Care, LLC

  • Home Health Agency
  • McAllen, TX
  • NPI 1952602849

  5% Or Greater Direct Ownership Interest, 5% Or Greater Indirect Ownership Interest, Corporate Director, Corporate Officer, General Partnership Interest, W-2 Managing Employee

  CMS ownership
• LD5 LLC

  dba Anchor of Love Hospice

  • Community Based Hospice Care Agency
  • McAllen, TX
  • NPI 1942800651

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Praise Wellness and Telehealth Clinic LLC

  • Nurse Practitioner
  • McAllen, TX
  • NPI 1497603195
  Medicare reassignment NPD Authorized official
• DHC Divine Health Care, LLC

  • Home Health Agency
  • McAllen, TX
  • NPI 1902356918
  NPD Authorized official
• DHC Divine Health Care, LLC

  • Home Health Agency
  • McAllen, TX
  • NPI 1952602849
  NPD Authorized official
• LD5 LLC

  dba Anchor of Love Hospice

  • Community Based Hospice Care Agency
  • McAllen, TX
  • NPI 1942800651
  NPD Authorized official

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1053047209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6913 N 40TH ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785045400",
            "telephone_number": "956-534-1471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 N 40TH ST",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785045400",
            "telephone_number": "956-534-1471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUM",
        "first_name": "LISA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1084712",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1084712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Dee Blankenship-Palacios, PT
• Lisa Ann Blevins, SPEECH PATHOLOGIST
• Blooming Counseling Center, PLLC
• Blue Puzzle
• Blueline DME, LLC.
• Emma Gene Bocanegra, BA, ASSISTANT SLP
• Marcelo Moreira Boek, M.D.
• Cheryl Boenig, P.T.
• Karen Bolalin
• Leonel Bolalin

• Nurse Practitioner in McAllen, TX
• Providers in McAllen, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.