Mary Ellen Teresa Blakesley, BS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

2000 Commerce Dr
Melbourne, FL 32904-2335

Phone

(321) 409-2170

Fax

(321) 676-6652

NPI assigned

Mar 26, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073630786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 COMMERCE DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329042335",
            "telephone_number": "321-409-2170",
            "fax_number": "321-676-6652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 COMMERCE DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329042335",
            "telephone_number": "321-409-2170",
            "fax_number": "321-676-6652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKESLEY",
        "first_name": "MARY ELLEN",
        "middle_name": "TERESA",
        "name_prefix": "Ms.",
        "credential": "BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miltiyia Blain, MSN, APRN, FNP-C
• Germaine M Blaine, MD
• Katelyn Blair
• Michelle Catherine Blair, N.N.P- B.C.
• Marie G Blaise
• Gustavo Dario Blancas, ARNP
• Christina Blanchard, APRN
• Andrew Blanke, CAA
• Erika Rae Blanke, CAA
• Stacey Renee Blanks

• All providers in Melbourne, FL
• Case Manager/Care Coordinator in Florida

• 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.