Katherine A Blake, APRN BC

Primary specialty

Clinical Nurse SpecialistTaxonomy code 364S00000X

License

104897 Issued in MA

Practice address

55 Pleasant Street
Newbury Port, MA 01950

Phone

(978) 462-0302

Fax

(978) 499-0226

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Katherine A Gendron Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073609301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PLEASANT STREET",
            "city": "NEWBURY PORT",
            "state": "MA",
            "postal_code": "01950",
            "telephone_number": "978-462-0302",
            "fax_number": "978-499-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PLEASANT STREET",
            "city": "NEWBURY PORT",
            "state": "MA",
            "postal_code": "01950",
            "telephone_number": "978-462-0302",
            "fax_number": "978-499-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KATHERINE",
        "middle_name": "A",
        "credential": "APRN BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "MA",
            "license": "104897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "PN0059",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "708967",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "GENDRON",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alec Biese
• Bio-Medical Applications of Massachusetts, Inc. (Fresenius Medical Care of Newburyport)
• Bethany A Bishop Daniels, M.D.
• Joanna Harmony Blabac, LMHC
• Robin S. Blair, O.D.
• Nancy M Bodwell, MSW LICSW
• Sheryn Faith Bonder, LICSW
• Tammy B Bottner, M.D.
• Katherine Anne Bourne, MD
• Kelly Bowen

• Clinical Nurse Specialist in Newburyport, MA
• Providers in Newburyport, MA by specialty
• Clinical Nurse Specialist in Massachusetts

• 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.