Active NPI
Jessica Anne Blake, APRN-NP, FNP-C
- Family Nurse Practitioner
- Omaha, NE
National Provider Identifier
1609406446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 112873
- Practice address
- 11949 Q St
Omaha, NE 68137-3503 - Phone
- (402) 595-1326
- NPI assigned
- Jan 21, 2020
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 112873 | NE | Primary |
Addresses
Primary practice location
11949 Q St
Omaha, NE 68137-3503
Mailing address
11949 Q St
Omaha, NE 68137-3503
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112873 | NE | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lincoln Lancaster County Child Advocacy Center | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Adolescent and Children Mental Health Clinic/Center
- Lincoln, NE
- NPI 1275668535
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579564800000",
"number": "1609406446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11949 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11949 Q ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681373503",
"telephone_number": "402-595-1326"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "JESSICA",
"middle_name": "ANNE",
"credential": "APRN-NP, FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-21",
"last_updated": "2020-01-21",
"certification_date": "2020-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NE",
"license": "112873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.