Individual provider Active NPI

Rachel Blackwell, NP

  • Nurse Practitioner
  • Binghamton, NY
National Provider Identifier
1376954198
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5013919 Issued in NC
Practice address
169 Riverside Dr
Binghamton, NY 13905-4246
Phone
(607) 798-5671
Fax
(888) 241-1404
NPI assigned
May 14, 2014
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5013919 NC Primary
Nurse Practitioner 363L00000X 3389681 NY
Family Nurse Practitioner 363LF0000X 3389681 NY

Addresses

Primary practice location

169 Riverside Dr
Binghamton, NY 13905-4246

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 577-6352

Other names 1

  • Rachel Laufersweiler Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141020000617 NY Practitioner - Nurse Practitioner 9931320892 Reassigns benefits to 1 organization
I20190925003301 SC Practitioner - Nurse Practitioner 9931320892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Hospitalist Services PCGroup PAC ID 3476855420, 301 clinicians

Practice addresses (Care Compare)

222 Herlong Ave S
Rock Hill, SC 29732-1158
Phone (803) 329-1234

809 82ND Pkwy
Myrtle Beach, SC 29572-4607
Phone (843) 692-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3389681NYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hospitalist Services PC Nurse Practitioner CurrentSince Sep 1, 2019 Accepting new patients
Curana Health of South Carolina PC CurrentSince Oct 10, 2019 Accepting new patients
Cogent Medical Care PC Nurse Practitioner CurrentSince Apr 1, 2015 Accepting new patients

Locations

169 Riverside Dr
Binghamton, NY 13905
Phone (607) 798-5111

565 Abbott Rd
Rm 8632
Buffalo, NY 14220
Phone (607) 798-5671

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

255 Midland Pkwy
Summerville, SC 29485
Phone (843) 821-5005

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1376954198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275064",
            "telephone_number": "615-577-6352",
            "fax_number": "615-810-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 RIVERSIDE DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139054246",
            "telephone_number": "607-798-5671",
            "fax_number": "888-241-1404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "RACHEL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5013919",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "3389681",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "3389681",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RACHEL",
            "last_name": "LAUFERSWEILER",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.