Individual provider Active NPI

Pamela Jean Blakemore-Ray, FNP

  • Family Nurse Practitioner
  • Kalamazoo, MI
National Provider Identifier
1578090536
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704265284 Issued in MI
Practice address
5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098
Phone
(269) 775-8031
NPI assigned
May 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704265284 MI Primary

Addresses

Primary practice location

5623 Gull Rd Ste 500
Kalamazoo, MI 49048-1098

Mailing address

601 John Street
Box 39
Kalamazoo, MI 49007-8242

Other practice location 1

451 Health Pkwy Ste F
Paw Paw, MI 49079-8242
Phone (269) 655-0761

Other practice location 2

6220 W Main St
Kalamazoo, MI 49009-8925
Phone (269) 276-4744

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170725000343 MI Practitioner - Nurse Practitioner 0143590125 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bronson Methodist HospitalGroup PAC ID 0244148633, shared by 3 NPIs, 721 clinicians

Practice addresses (Care Compare)

5623 Gull Rd
Suite 500
Kalamazoo, MI 49048-1097
Phone (269) 775-8031

5629 Stadium Dr B
Kalamazoo, MI 49009-1952
Phone (269) 544-3270

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.43 of 100Reported as group
Quality
75.38
Promoting interoperability
100
Improvement activities
40
Cost
79.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704265284MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital CurrentSince Aug 20, 2017 Accepting new patients
Bronson Methodist Hospital Family CurrentSince Sep 16, 2019 Accepting new patients
Bronson Methodist Hospital CurrentSince Sep 16, 2019 Accepting new patients
Bronson Lakeview Hospital Family Medicine CurrentSince Aug 20, 2017 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

2900 Watkins Rd
Battle Creek, MI 49015
Phone (269) 245-5430

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

5623 Gull Rd
Ste 500
Kalamazoo, MI 49048
Phone (269) 775-8031

601 John St
#39
Kalamazoo, MI 49007

601 John St
#2
Kalamazoo, MI 49007

5629 Stadium Dr
Ste B
Kalamazoo, MI 49009
Phone (269) 544-3270

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

451 Health Pkwy
Ste F
Paw Paw, MI 49079
Phone (269) 655-3080

955 S Bailey Ave
Ste 200
South Haven, MI 49090
Phone (269) 639-2720

950 S Bailey Ave
South Haven, MI 49090
Phone (269) 639-2796

970 S Bailey Ave
South Haven, MI 49090
Phone (269) 637-2916

Interoperability endpoints

  • Direct secure messaging: direct@direct.bronsonhg.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1495238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1578090536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN STREET",
            "address_2": "BOX 39",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490078242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5623 GULL RD STE 500",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490481098",
            "telephone_number": "269-775-8031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "451 Health Pkwy Ste F",
            "address_purpose": "LOCATION",
            "city": "Paw Paw",
            "state": "MI",
            "postal_code": "490798242",
            "country_code": "US",
            "telephone_number": "269-655-0761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6220 W Main St",
            "address_purpose": "LOCATION",
            "city": "Kalamazoo",
            "state": "MI",
            "postal_code": "490098925",
            "country_code": "US",
            "telephone_number": "269-276-4744",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKEMORE-RAY",
        "first_name": "PAMELA",
        "middle_name": "JEAN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-20",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704265284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.