Active NPI
Christine M Blue, DO
- Geriatric Psychiatry Physician
- Lewisburg, WV
National Provider Identifier
1093786683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Psychiatry Physician
- License
- 1927
- Practice address
- 400 N Jefferson St
Lewisburg, WV 24901-9503 - Phone
- (304) 645-3220
- Fax
- (304) 645-4103
- NPI assigned
- Jan 31, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Geriatric Psychiatry Physician | 2084P0805X | 1927 | WV | Primary |
Addresses
Primary practice location
400 N Jefferson St
Lewisburg, WV 24901-9503
Mailing address
400 N Jefferson St
Lewisburg, WV 24901-9503
Phone (304) 645-3220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 184749000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1927 | WV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389916800000",
"number": "1093786683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 N JEFFERSON ST",
"city": "LEWISBURG",
"state": "WV",
"postal_code": "249019503",
"telephone_number": "304-645-3220",
"fax_number": "304-645-4103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N JEFFERSON ST",
"city": "LEWISBURG",
"state": "WV",
"postal_code": "249019503",
"telephone_number": "304-645-3220",
"fax_number": "304-645-4103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "CHRISTINE",
"middle_name": "M",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-31",
"last_updated": "2014-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0805X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Geriatric Psychiatry",
"state": "WV",
"license": "1927",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184749000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewisburg, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.