Charles Blagovich

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

121198 Issued in OK

Practice address

6600 S Yale Ave
Tulsa, OK 74136-3347

Phone

(740) 505-7569

NPI assigned

Jul 11, 2016

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

Enrolled in OK

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nujoint LLCGroup PAC ID 5799155172, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Nujoint LLC

  • Clinic/Center
  • Bartlesville, OK
  • NPI 1609539683
  Medicare reassignment Care Compare group NPD
• Medical Resource Management, LLC

  • Urgent Care Clinic/Center
  • Edmond, OK
  • NPI 1104056365
  Medicare reassignment NPD
• Tulsa Emergency Medical Center Inc

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1063479087
  Medicare reassignment NPD
• Medexpress Urgent Care, PC - Oklahoma

  • Urgent Care Clinic/Center
  • Tulsa, OK
  • NPI 1710371448
  NPD

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1053763334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347",
            "telephone_number": "740-505-7569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363347",
            "telephone_number": "740-505-7569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGOVICH",
        "first_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "121198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah S Blackwell
• Stormie Blackwell
• Erin Blackwood, RD, LD.
• Holly Blackwood
• Joel Evan Blackwood, RPA
• Emily Blair, RN
• Geoffrey Blair, PA-C
• Jennifer Faith Blair, APRN
• Thomas Calvin Blair III
• Emily Grace Blais

• Family Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.