Individual provider Active NPI

Amy Blake, FNP-C

  • Family Nurse Practitioner
  • Jonesboro, LA
National Provider Identifier
1063838464
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP07742 Issued in LA
Practice address
244 Bond St
Jonesboro, LA 71251-5334
Phone
(318) 259-1100
Fax
(318) 259-1333
NPI assigned
Mar 10, 2014
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP07742 LA Primary

Addresses

Primary practice location

244 Bond St
Jonesboro, LA 71251-5334

Mailing address

PO Box 70
Hodge, LA 71247-0070
Phone (318) 259-1100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20140505000032 LA Practitioner - Nurse Practitioner 2961635644 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP07742LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Health Center CurrentSince Nov 17, 2025 Accepting new patients
C H Wilkinson Physician Network Nurse Practitioner CurrentSince Jan 1, 2015 Accepting new patients
C H Wilkinson Physician Network CurrentSince Jan 1, 2015 Accepting new patients
Access Health Louisiana PastSince Sep 11, 2022 Accepting new patients
Access Health Louisiana Past Accepting new patients
Access Health Louisiana PastSince Aug 1, 2022 Accepting new patients
Access Health Louisiana PastSince Sep 4, 2022 Accepting new patients
Access Health Louisiana PastSince Sep 11, 2022 Accepting new patients

Locations

244 Bond St
Jonesboro, LA 71251
Phone (318) 259-1100

1 Saint Mary Pl
Shreveport, LA 71101
Phone (318) 681-4500

Interoperability endpoints

  • Direct secure messaging: amy.blake.1@11331.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1063838464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "HODGE",
            "state": "LA",
            "postal_code": "712470070",
            "telephone_number": "318-259-1100",
            "fax_number": "318-259-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 BOND ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712515334",
            "telephone_number": "318-259-1100",
            "fax_number": "318-259-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "AMY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP07742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, LA

Sources for this page

Verify at the official NPI Registry.