Individual provider Active NPI

Michael Goldblatt

  • Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1275996639
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
24799 Issued in TN
Practice address
1 Medical Center Blvd
Cookeville, TN 38501-4294
Phone
(931) 783-2770
Fax
(931) 525-1176
NPI assigned
Apr 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X ARNP9282649 FL
Acute Care Nurse Practitioner 363LA2100X 24799 TN
Nurse Practitioner 363L00000X 24799 TN Primary
Critical Care Medicine Registered Nurse 163WC0200X ARNP 9282649 FL

Addresses

Primary practice location

1 Medical Center Blvd
Cookeville, TN 38501-4294

Mailing address

127 N Oak Ave Ste D
Cookeville, TN 38501-2435
Phone (931) 783-5857

Other practice location 1

601 E Rollins St
Critical Care Specialists
Orlando, FL 32803-1248
Phone (407) 303-7283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160727002185 FL Practitioner - Nurse Practitioner 5991098014 Reassigns benefits to 1 organization
I20190320001455 TN Practitioner - Nurse Practitioner 5991098014 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cookeville Hospitalist Group PLLCGroup PAC ID 1254794282, 56 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Blvd
Cookeville, TN 38501-4294
Phone (931) 528-2541

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP 9282649FLMDCritical Care Medicine Registered Nurse
24799TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
App of Tennessee HM, PLLC Nurse Practitioner CurrentSince Jul 1, 2019 Accepting new patients
Florida Hospital Medical Group Inc Nurse Practitioner CurrentSince Jun 13, 2016 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jun 13, 2016 Accepting new patients
Cookeville Hospitalist Group, PLLC CurrentSince Aug 1, 2023 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

2501 N Orange Ave
Ste 401
Orlando, FL 32804

1 Medical Center Blvd
Cookeville, TN 38501
Phone (931) 783-2334

106 Medical Center Blvd
Fayetteville, TN 37334
Phone (931) 438-1100

2835 Highway 231 N
Shelbyville, TN 37160
Phone (931) 685-5433

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1275996639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N OAK AVE STE D",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385012435",
            "telephone_number": "931-783-5857",
            "fax_number": "931-526-6760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014294",
            "telephone_number": "931-783-2770",
            "fax_number": "931-525-1176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 E Rollins St",
            "address_2": "Critical Care Specialists",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328031248",
            "country_code": "US",
            "telephone_number": "407-303-7283",
            "fax_number": "407-303-0347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDBLATT",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-03",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "ARNP9282649",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "24799",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "24799",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "FL",
            "license": "ARNP 9282649",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.