Sally Ann Blomgren, R.N. M.S. C.S.

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

151021 Issued in MA

Practice address

78 Burncoat St
Worcester, MA 01605-1350

Phone

(508) 414-5469

Fax

(508) 870-7684

NPI assigned

Oct 13, 2006

Last updated

Feb 26, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MA

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

Certified Clinical Nurse Specialist (CNS)

Education

Other, 1999

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Master of Science, Registered Nurse

State licenses

Practice roles

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.

• Norma L. Medway, Psy.D.PC

  • Psychologist
  • Worcester, MA
  • NPI 1124176797
  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1619067568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 BURNCOAT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051350",
            "telephone_number": "508-414-5469",
            "fax_number": "508-870-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 BURNCOAT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051350",
            "telephone_number": "508-414-5469",
            "fax_number": "508-870-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOMGREN",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "R.N. M.S. C.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "151021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2089549",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7807539",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "471005",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUE SHIELD",
            "identifier": "PN0758",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1034280",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "411421",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blended Hearts Home Care, LLC
• Stephanie L Blenner, M.D.
• Rachel Ann Blessington, CNM, LMT
• Rena Blette
• Kathryn Blinn
• Brooke Elizabeth Bloom, DO
• Marlo Bloom, MA
• Blooming Staffing Agency Inc
• Evan Blouin
• Michelle Elizabeth Blouin

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Worcester, MA
• Providers in Worcester, MA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2016; 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.