Active NPI
Marvel Jean Blazek, ARNP
- Family Nurse Practitioner
- Greenfield, IA
National Provider Identifier
1275587701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A047506
- Practice address
- 609 SE Kent St
Greenfield, IA 50849-9454 - Phone
- (641) 743-6189
- Fax
- (641) 743-6217
- NPI assigned
- May 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A047506 | IA | Primary |
Addresses
Primary practice location
609 SE Kent St
Greenfield, IA 50849-9454
Mailing address
609 SE Kent St
Greenfield, IA 50849-9454
Phone (641) 743-2123
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32933 | Other | IA | BLUE CROSS/BLUE SHIELD |
| 3283259 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| A047506 | IA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375660800000",
"number": "1275587701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "609 SE KENT ST",
"city": "GREENFIELD",
"state": "IA",
"postal_code": "508499454",
"telephone_number": "641-743-2123",
"fax_number": "641-743-7292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 SE KENT ST",
"city": "GREENFIELD",
"state": "IA",
"postal_code": "508499454",
"telephone_number": "641-743-6189",
"fax_number": "641-743-6217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAZEK",
"first_name": "MARVEL",
"middle_name": "JEAN",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-20",
"last_updated": "2013-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IA",
"license": "A047506",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "32933",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3283259",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenfield, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.