Connie Robbins Blokkum, CNM, IBCLC

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

256351 Issued in TX

Practice address

1002 Avenue a
Katy, TX 77493-2462

Phone

(281) 395-6652

Fax

(281) 391-9081

NPI assigned

Aug 31, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340409600000",
    "number": "1528375375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 AVENUE A",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932462",
            "telephone_number": "281-395-6652",
            "fax_number": "281-391-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 AVENUE A",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774932462",
            "telephone_number": "281-395-6652",
            "fax_number": "281-391-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOKKUM",
        "first_name": "CONNIE",
        "middle_name": "ROBBINS",
        "name_prefix": "Mrs.",
        "credential": "CNM, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-31",
        "last_updated": "2012-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "TX",
            "license": "256351",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "256351",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "TX",
            "license": "256351",
            "primary": false
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "256351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Practice Midwife in Katy, TX
• Providers in Katy, TX by specialty
• Advanced Practice Midwife in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2012; 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.