Individual provider Active NPI

Blake Durnell

  • Internal Medicine Physician
  • Omaha, NE
National Provider Identifier
1356085120
Registry record updated Jul 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LP05733 Issued in RI
Practice address
7710 Mercy Rd Dept of
Omaha, NE 68124-2372
Phone
(402) 717-0820
NPI assigned
Apr 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X LP05733 RI Primary

Addresses

Primary practice location

7710 Mercy Rd Dept of
Omaha, NE 68124-2372

Mailing address

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220707001976 RI Order and Referring Only - EndocrinologyPractitioner - EndocrinologyPractitioner - Internal Medicine 4981084019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10205NEMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1356085120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD STE 202",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7710 MERCY RD DEPT OF",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681242372",
            "telephone_number": "402-717-0820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURNELL",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP05733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

Verify at the official NPI Registry.