Individual provider Active NPI

Tenekwa Blair, NURSE AID

  • Home Health Aide
  • Carbondale, IL
National Provider Identifier
1124980057
Registry record updated Nov 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
612 E Campus Dr Apt C6
Carbondale, IL 62901-3827
Phone
(217) 652-8457
NPI assigned
Dec 1, 2025
Last updated
Nov 5, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X IL Primary
Non-emergency Medical Transport (VAN) 343900000X IL

Addresses

Primary practice location

612 E Campus Dr Apt C6
Carbondale, IL 62901-3827

Mailing address

612 E Campus Dr Apt C6
Carbondale, IL 62901-3827
Phone (217) 652-8457

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)
Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793836800000",
    "number": "1124980057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E CAMPUS DR APT C6",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013827",
            "telephone_number": "217-652-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E CAMPUS DR APT C6",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013827",
            "telephone_number": "217-652-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "TENEKWA",
        "credential": "NURSE AID",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-01",
        "last_updated": "2026-11-05",
        "certification_date": "2026-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2026; 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.