Active NPI
Natalie Blonski
- Gerontology Nurse Practitioner
- Detroit, MI
National Provider Identifier
1336637008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 4704297408
- Practice address
- 2799 W Grand Blvd
Detroit, MI 48202 - Phone
- (313) 916-2600
- NPI assigned
- Apr 27, 2018
- Last updated
- Nov 27, 2023
- 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 |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 4704297408 | MI | Primary |
Addresses
Primary practice location
2799 W Grand Blvd
Detroit, MI 48202
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2689
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4704297408 | Other | MI | MICHIGAN LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.henryford.com/locations/henry-ford-hospital | Henry Ford Health System |
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
- Certified Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1524787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1336637008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482022689"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2799 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-916-2600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLONSKI",
"first_name": "NATALIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-04-27",
"last_updated": "2023-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "MI",
"license": "4704297408",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN LICENSE",
"identifier": "4704297408",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.henryford.com/locations/henry-ford-hospital",
"affiliation": "Y",
"affiliationName": "Henry Ford Health System",
"address_1": "2799 W Grand Blvd",
"city": "Detroit",
"state": "MI",
"country_code": "US",
"postal_code": "48202",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- 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.