Jolene Lynne Blaine, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

19666 Issued in NV

Practice address

1812 E Charleston Blvd
Las Vegas, NV 89104-1951

Phone

(702) 384-5047

NPI assigned

Apr 6, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jolene.blaine@cvshealth.com

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.

• Nevada CVS Pharmacy LLC

  • Pharmacy
  • Las Vegas, NV
  • NPI 1528581865
  NPD (past)

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1306475892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041951",
            "telephone_number": "702-384-5047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAINE",
        "first_name": "JOLENE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NV",
            "license": "19666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jolene.Blaine@cvshealth.com",
            "affiliation": "Y",
            "affiliationName": "CVS Pharmacy, Inc",
            "address_1": "1812 E Charleston Blvd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891041951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katelynn Blad
• Melissa Bladen
• Shanice Blades, RN
• Martin Blahnik, MD
• Blaine R Hansen, DMD, Ms
• Blair a Isom DDS LTD
• Blair Thomas DMD PLLC
• Chantil Blair
• Chyna Blair
• Geionni Laneece Marie Blair

• Pharmacist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pharmacist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.