Individual provider Active NPI

Karen K Blamer, NP

  • Family Nurse Practitioner
  • Portage, MI
National Provider Identifier
1215907795
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704108809 Issued in MI
Practice address
3300 W Centre Ave
Portage, MI 49024-4666
Phone
(269) 324-8950
Fax
(269) 324-2134
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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 4704108809 MI Primary

Addresses

Primary practice location

3300 W Centre Ave
Portage, MI 49024-4666

Mailing address

3300 W Centre Ave
Portage, MI 49024-4666
Phone (269) 324-8950

Other identifiers 1

IdentifierTypeStateIssuer
4427523MedicaidMI

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704108809MIMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kblamer2207@direct.bronsonhg.org

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1215907795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244666",
            "telephone_number": "269-324-8950",
            "fax_number": "269-324-2134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244666",
            "telephone_number": "269-324-8950",
            "fax_number": "269-324-2134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAMER",
        "first_name": "KAREN",
        "middle_name": "K",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704108809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4427523",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.

Verify at the official NPI Registry.