Nicole Blum, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11006521 Issued in FL

Practice address

4712 Arthur St
Hollywood, FL 33021-4737

Phone

(954) 895-1004

NPI assigned

Apr 22, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Vitalmd Group Holding LLC

  • Obstetrics & Gynecology Physician
  • Miami, FL
  • NPI 1871572032
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1255951026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ARTHUR ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330214737",
            "telephone_number": "954-895-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 ARTHUR ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330214737",
            "telephone_number": "954-895-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4712 Arthur St",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330214737",
            "country_code": "US",
            "telephone_number": "954-895-1004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUM",
        "first_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11006521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Ribbon Medical Equipment LLC
• Blue Water Pain Solutions, PA
• Blue Water Pain Solutions, PA
• Bluhope LLC
• Deborah Blum
• Bluma Dukesz OD PLLC
• Andrea Klein Blumberg, M.D.
• Jennifer Lisa Bluth, PH,D, LCSW
• Daniel Ivan Bober, DO
• Eric Boccio, MD, MPH, FACEP

• Family Nurse Practitioner in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.