Maryann B Blevins, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

083185 Issued in MO

Practice address

3525 S National Ave
#105
Springfield, MO 65807-7310

Phone

(417) 840-0802

Fax

(417) 269-1098

NPI assigned

Sep 20, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1073610895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4046",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658084046",
            "telephone_number": "417-269-5712",
            "fax_number": "417-269-7567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3525 S NATIONAL AVE",
            "address_2": "#105",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658077310",
            "telephone_number": "417-840-0802",
            "fax_number": "417-269-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "MARYANN",
        "middle_name": "B",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "083185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428408405",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MO",
            "identifier": "181509",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Breanne Blasczyk, PA-C
• Jonathan D Bledsoe, MA, LPC
• Allison Noreen Blevins, MA, LPCC, NCC
• Elaine Blevins, NP-C
• Lisa J Blevins
• Paul D Blisard, ED.D., L.P.C.
• Jenetta D Bliss, CRNA
• Michael P Bliss, CRNA
• Bloom Well LLC
• Alida M. Bloom, RN, CS, FNP

• Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.