Individual provider Active NPI

Nancy Jean Blentlinger-Marshall, A.P.N

  • Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1306959317
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
41-180204 Issued in IL
Practice address
901 Southwind Dr
Springfield, IL 62703-5125
Phone
(217) 786-6994
Fax
(217) 786-0193
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 41-180204 IL Primary

Addresses

Primary practice location

901 Southwind Dr
Springfield, IL 62703-5125

Mailing address

901 Southwind Dr
Springfield, IL 62703-5125
Phone (217) 786-6994

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
41-180204ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306959317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SOUTHWIND DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035125",
            "telephone_number": "217-786-6994",
            "fax_number": "217-786-0193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SOUTHWIND DR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035125",
            "telephone_number": "217-786-6994",
            "fax_number": "217-786-0193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLENTLINGER-MARSHALL",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "A.P.N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "41-180204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.