Blake's Mobile Medical Labs and Services, LLC

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Legal business name

BLAKE'S MOBILE MEDICAL LABS AND SERVICES, LLC

Doing business as

Blake's Mobile Labs

Practice address

3201 Edwards Mill Rd Ste 141
Raleigh, NC 27612-5371

Phone

(919) 400-0383

NPI assigned

May 6, 2021

Last updated

May 6, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Blake

Title

Ceo

Phone

(919) 400-0383

Specialties & licenses 1

Addresses

Other names 1

• Blake's Mobile Labs Doing business as

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

{
    "created_epoch": "1620259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620259200000",
    "number": "1083298194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 EDWARDS MILL RD STE 141",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125371",
            "telephone_number": "919-400-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 EDWARDS MILL RD STE 141",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125371",
            "telephone_number": "919-400-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE'S MOBILE MEDICAL LABS AND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-06",
        "last_updated": "2021-05-06",
        "certification_date": "2021-04-07",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-400-0383"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blake's Mobile Labs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jarrett Christian Blaize, LCSW
• Anna Blake
• Cynthia Salmon Blake, LPN
• Terynn Elizabeth Blake, DNP, BSN, RN, CRNA
• Vanessa Lynn Blake, FNP-C
• Cynthia Blakely, LPN
• Malikata Rahima Blakey, M.ED
• Sandra Cochrane Blakney, M.D.
• Lutrino Marcell Blalock, M.A. L.P.A.
• Janis Leigh Blanchard, WHNP CNM

• Community Health Worker in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Community Health Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; 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.