Individual provider Active NPI

Blakney Jane Ciccolo

  • Registered Nurse
  • Sudbury, MA
National Provider Identifier
1366319246
Registry record updated Oct 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN208217 Issued in MA
Practice address
29 Hudson Rd Ste 3310
Sudbury, MA 01776-1753
Phone
(978) 443-8810
Fax
(978) 443-8839
NPI assigned
Oct 23, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN208217 MA Primary

Addresses

Primary practice location

29 Hudson Rd Ste 3310
Sudbury, MA 01776-1753

Mailing address

29 Hudson Rd Ste 3310
Sudbury, MA 01776-1753
Phone (978) 443-8810

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN208217MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1761177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761177600000",
    "number": "1366319246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 HUDSON RD STE 3310",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761753",
            "telephone_number": "978-443-8810",
            "fax_number": "978-443-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 HUDSON RD STE 3310",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017761753",
            "telephone_number": "978-443-8810",
            "fax_number": "978-443-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOLO",
        "first_name": "BLAKNEY",
        "middle_name": "JANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-23",
        "last_updated": "2025-10-23",
        "certification_date": "2025-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN208217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2025; 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.