Individual provider Active NPI

Carolyn Mae Blouir, FNP-C

  • Family Nurse Practitioner
  • Portage, IN
National Provider Identifier
1174024939
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71007816A Issued in IN
Practice address
3545 Arbor Blvd Ste E
Portage, IN 46368-4298
Phone
(219) 947-6920
Fax
(219) 947-6921
NPI assigned
Feb 26, 2018
Last updated
Aug 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71007816A IN Primary

Addresses

Primary practice location

3545 Arbor Blvd Ste E
Portage, IN 46368-4298

Mailing address

3545 Arbor Blvd Ste E
Portage, IN 46368-4298
Phone (219) 947-6920

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Carolyn.Blouir@comhs.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180321001774 IN Practitioner - Nurse Practitioner 6709148208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Indiana University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

3545 Arbor Blvd
Suite E
Portage, IN 46368-4298
Phone (219) 947-6920

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bikashagarwal Inc. CurrentSince Feb 21, 2018 Accepting new patients
Community Care Network Inc Nurse Practitioner CurrentSince Sep 20, 2021 Accepting new patients
Healthpartners Medical Group, LLC PastSince Sep 17, 2018 Accepting new patients

Locations

1507 Wabash St
Ste 500B
Michigan City, IN 46360
Phone (219) 805-5333

802 E US Highway 20
Michigan City, IN 46360
Phone (219) 872-7251

8733 W 400 N
Michigan City, IN 46360
Phone (219) 879-0330

8865 W 400 N
Ste 105
Michigan City, IN 46360
Phone (219) 861-8740

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

3545 Arbor Blvd
Ste E
Portage, IN 46368
Phone (219) 947-6920

Interoperability endpoints

  • Direct secure messaging: carolyn.blouir@comhs.org
  • Direct secure messaging: cblouir121839@ssdirect.comhs.org

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1174024939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 ARBOR BLVD STE E",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684298",
            "telephone_number": "219-947-6920",
            "fax_number": "219-947-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 ARBOR BLVD STE E",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684298",
            "telephone_number": "219-947-6920",
            "fax_number": "219-947-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOUIR",
        "first_name": "CAROLYN",
        "middle_name": "MAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-26",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71007816A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Carolyn.Blouir@comhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3545 Arbor Blvd Ste E",
            "city": "Portage",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463684298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Portage, IN

Sources for this page

Verify at the official NPI Registry.