Amy Josephine Blake, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704322193 Issued in MI

Practice address

4100 John R St
Detroit, MI 48201-2013

Phone

(800) 527-6266

NPI assigned

Aug 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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 1

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Physician GroupGroup PAC ID 8628087681, 399 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Karmanos Cancer Center Hospital, Detroit, MI, CCN 230297

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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

• University Physician Group

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1447299797
  Medicare reassignment Care Compare group NPD
• Barbara Ann Karmanos Cancer Institute

  • Mammography Clinic/Center
  • Detroit, MI
  • NPI 1225022288
  Medicare reassignment NPD
• Barbara Ann Karmanos Cancer Institute

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Detroit, MI
  • NPI 1386060226
  NPD
• Barbara Ann Karmanos Cancer Institute

  • Community Based Hospice Care Agency
  • Southfield, MI
  • NPI 1740275387
  NPD (past)
• University Physician Group

  • Social Worker
  • Livonia, MI
  • NPI 1154360402
  NPD (past)

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

• Barbara Ann Karmanos Cancer Hospital

  • General Acute Care Hospital
  • Detroit, MI
  • NPI 1316900277
  Care Compare affiliation

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

{
    "created_epoch": "1596931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1467062950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 JUNCTION ST",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481701134",
            "telephone_number": "248-229-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 JOHN R ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012013",
            "telephone_number": "800-527-6266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "AMY",
        "middle_name": "JOSEPHINE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-09",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704322193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger Radd Blair, MSW
• Ingrid L Blair, RN
• Lisa Blair
• Monique Danielle Blair
• Patricia Blake-Smith, MSPH
• Ania Jamie Blake, DDS
• Cortez Santino Blake Sr.
• Danielle Blake, FNP-C
• Dionne Blake
• Gail Ann Blake, LPN

• Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.