Angela Lynn Blake, DNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

747465 Issued in ID

Practice address

16760 N Highway 41
Rathdrum, ID 83858-8715

Phone

(208) 687-5627

NPI assigned

Aug 15, 2023

Last updated

Dec 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Angela Lynn Aragon Former name

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dirne Health Centers IncGroup PAC ID 2466353354, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eden Home Health Home health agency, Ponderay, ID, CCN 137122
• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.blake.1@16899.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dirne Health Centers, Inc.

  dba Heritage Health Main

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1285686477

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240

  Nurse Practitioner

  NPD
• Dirne Health Centers, Inc.

  dba Heritage Family Support Services of North Idaho

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1255756730

  Nurse Practitioner

  NPD

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

• Eden Home Health of Sandpoint, LLC

  dba Eden Home Health

  • Home Health Agency
  • Ponderay, ID
  • NPI 1346898830
  Care Compare affiliation
• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur d'Alene, ID
  • NPI 1992798409
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  dba Northwest Specialty Hospital

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1692057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1598548463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16760 N HIGHWAY 41",
            "city": "RATHDRUM",
            "state": "ID",
            "postal_code": "838588715",
            "telephone_number": "208-687-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "ANGELA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-15",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "747465",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "747465",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "ARAGON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Alverson, LCSW
• At Home Physical Therapy Services, PLLC
• Brett Joseph Barna, P.T.
• Joshua B Bartoo, M.P.T.
• Duncan Bell, RPH
• Stephanie Rae Bowen, MD
• Rebekah Laura Bradford, MA, BIP
• Tina Marie Broadsword, LMSW
• Craig Cahan, PT, DPT
• David Cannon, LPC

• Nurse Practitioner in Rathdrum, ID
• Providers in Rathdrum, ID by specialty
• Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.