Kacy Bladergroen, A.R.N.P.

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN9264276 Issued in FL

Practice address

2150 SE Salerno Rd Ste 200
Stuart, FL 34997-6572

Phone

(772) 223-5777

NPI assigned

Mar 9, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbladergroen2496280@direct.ccf.org

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.

• Martin Memorial Medical Center Inc

  • General Acute Care Hospital
  • Stuart, FL
  • NPI 1194790055

  Single Specialty

  Medicare reassignment NPD
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1508007329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 SE SALERNO RD STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976572",
            "telephone_number": "772-223-5777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 SE SALERNO RD STE 200",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349976572",
            "telephone_number": "772-223-5777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Nebraska Ave",
            "address_2": "Suite 113",
            "address_purpose": "LOCATION",
            "city": "Fort Pierce",
            "state": "FL",
            "postal_code": "349504704",
            "country_code": "US",
            "telephone_number": "772-460-0321",
            "fax_number": "772-460-0332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLADERGROEN",
        "first_name": "KACY",
        "credential": "A.R.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "9264276",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9264276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sade Blackshear, LMHC
• Briana Kay Blackwell
• Charles Robert Blackwell, D.O.
• Hugh Blackwood
• Navia Blackwood, RN, BSN
• Gregory Michael Blake, PHARMD
• Lynnette R Blake, ND
• Christopher Blanchard
• Allison Katheryn Blanco
• Anais Blanco

• Pediatric Nurse Practitioner in Stuart, FL
• Providers in Stuart, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.