Active NPI
Jason Blake, PMHMP-BC
- Psychiatric/Mental Health Nurse Practitioner
- Cleveland, OH
National Provider Identifier
1083267348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- APRN.CNP.024969
- Practice address
- 10701 East Blvd
Cleveland, OH 44106-1702 - Phone
- (216) 791-3800
- NPI assigned
- Jul 16, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN.CNP.024969 | OH | Primary |
Addresses
Primary practice location
10701 East Blvd
Cleveland, OH 44106-1702
Mailing address
10701 East Blvd
Cleveland, OH 44106-1702
Phone (216) 791-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563235200000",
"number": "1083267348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10701 EAST BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061702",
"telephone_number": "216-791-3800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10701 EAST BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441061702",
"telephone_number": "216-791-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "JASON",
"credential": "PMHMP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-16",
"last_updated": "2019-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "OH",
"license": "APRN.CNP.024969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.