Individual provider Active NPI

Nicholas Blair, NP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1134621972
Registry record updated Nov 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-137905 Issued in AL
Practice address
3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone
(205) 971-1000
NPI assigned
Mar 7, 2018
Last updated
Nov 23, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-137905 AL Primary

Addresses

Primary practice location

3690 Grandview Pkwy
Birmingham, AL 35243-3326

Mailing address

3690 Grandview Pkwy
Birmingham, AL 35243-3326
Phone (205) 971-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618000444 AL Practitioner - Nurse Practitioner 1658626510 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-137905ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Mountain Group Services, LLC CurrentSince Apr 1, 2018 Accepting new patients
Oak Mountain Group Services, LLC CurrentSince Apr 1, 2018 Accepting new patients

Locations

3070 Healthy Way
Vestavia, AL 35243
Phone (205) 977-7216

3690 Grandview Pkwy
Vestavia, AL 35243
Phone (205) 592-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 2

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542931200000",
    "number": "1134621972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 GRANDVIEW PKWY",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352433326",
            "telephone_number": "205-971-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "NICHOLAS",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-137905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.