Heather Blazejewski, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN39878 Issued in RI

Practice address

650 Ten Rod Rd Unit 13
Family Service of Rhode Island, Inc
North Kingstown, RI 02852-4237

Phone

(401) 331-1350

Fax

(401) 277-3366

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

• Heather Clark Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427190859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 WALDRON AVE",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028526833",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 TEN ROD RD UNIT 13",
            "address_2": "FAMILY SERVICE OF RHODE ISLAND, INC",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524237",
            "telephone_number": "401-331-1350",
            "fax_number": "401-277-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEJEWSKI",
        "first_name": "HEATHER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN39878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC51253",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CLARK",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Lou Ann Botsford, LMT

• All providers in North Kingstown, RI
• Registered Nurse in Rhode Island

• 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.