Tracy Charleston-Blakes

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703091237 Issued in MI

Practice address

300 Candlewyck Dr Apt 1201
Kalamazoo, MI 49001-6800

Phone

(269) 271-7178

NPI assigned

Sep 11, 2024

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1467288902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CANDLEWYCK DR APT 1201",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490016800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CANDLEWYCK DR APT 1201",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490016800",
            "telephone_number": "269-271-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLESTON-BLAKES",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703091237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Marie Chapman, FNP-C
• Mitchell Chapman
• Matthew Perry Chappuies, LPN
• Megan E Charapata, BEHAVIOR TECHNICIAN
• Trevor Charbonneau
• Diana Charnley, PHD, LPC, NCC
• Sarah Elaine Charters, M.D.
• Madison Chase
• Taylor Marie Chastain, B.S., B.A.
• Robert Joseph Chatel, BA

• All providers in Kalamazoo, MI
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.