Active NPI
Blake Shareene Kadavy
- Registered Nurse
- Lincoln, NE
National Provider Identifier
1548926470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 86057
- Practice address
- 5905 O St
Lincoln, NE 68510-2235 - Phone
- (402) 436-1000
- NPI assigned
- Nov 15, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 86057 | NE | Primary |
Addresses
Primary practice location
5905 O St
Lincoln, NE 68510-2235
Mailing address
2537 S 36TH St
Lincoln, NE 68506-6630
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | bkadavy2@lps.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86057 | NE | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1548926470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2537 S 36TH ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685066630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5905 O ST",
"city": "LINCOLN",
"state": "NE",
"postal_code": "685102235",
"telephone_number": "402-436-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KADAVY",
"first_name": "BLAKE",
"middle_name": "SHAREENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NE",
"license": "86057",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "bkadavy2@lps.org",
"affiliation": "N",
"endpointDescription": "Work Email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "5905 O St",
"city": "Lincoln",
"state": "NE",
"country_code": "US",
"postal_code": "685102235",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Lincoln, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.