Rebecca Blaguski, CERTIFIED REGISTERED

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP021361 Issued in PA

Practice address

The Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104

Phone

(215) 316-5151

NPI assigned

May 6, 2020

Reactivated

Jul 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1114548690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1199 LUDLOW STREET",
            "address_2": "APARTMENT 2406",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19107",
            "telephone_number": "905-531-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE HOSPITAL OF THE UNIVERSITY OF PENNSYLVANIA",
            "address_2": "3400 SPRUCE STREET",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-316-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAGUSKI",
        "first_name": "REBECCA",
        "credential": "CERTIFIED REGISTERED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "deactivation_date": "2022-01-11",
        "reactivation_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN719286",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "PA",
            "license": "SP021361",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP021361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shariff Blackwell
• Ann-Marie Jenice Blackwood-Palmer
• Ethan S Blades
• Aaron Blady
• Anna Marie Blaeser, MD
• Eileen Blaha
• Caitlyn Blair, MS LAT ATC
• Erin Blair
• James Michael Blair, MD
• Logan Zachary Blair, MD

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.