Victoria L Blair, NURSE PRACTITIONER

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

N21972 Issued in ID

Practice address

2001 S Woodruff Ave Ste 15B
Idaho Falls, ID 83404-6372

Phone

(208) 357-4633

Fax

(208) 419-0690

NPI assigned

Jan 11, 2007

Last updated

Mar 23, 2018By 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 1

Addresses

Other identifiers 2

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, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medicine Hub PLLCGroup PAC ID 9537422662, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Aspen Home Health Services Home health agency, Idaho Falls, ID, CCN 137081
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: victoria.blair.1@19202.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.

• Family Medicine Hub PLLC

  dba Blair Family Medicine

  • Nurse Practitioner
  • Idaho Falls, ID
  • NPI 1134620107
  Medicare reassignment Care Compare group NPD
• Flower Aston Nutrition LLC

  • Health Service Clinic/Center
  • Idaho Falls, ID
  • NPI 1932961331
  NPD
• Teton Cardiovascular and Pulmonary Lab,LLC

  dba Snake River Cardiovascular & Pulmonary Laboratory

  • Physiological Laboratory
  • Idaho Falls, ID
  • NPI 1699784413
  NPD

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

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• The Aspen Group, Inc.

  dba Aspen Home Health

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1083760185
  Care Compare affiliation

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1629128483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1783",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031783",
            "telephone_number": "208-552-8774",
            "fax_number": "208-523-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 15B",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046372",
            "telephone_number": "208-357-4633",
            "fax_number": "208-419-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "VICTORIA",
        "middle_name": "L",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "N21972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER",
            "identifier": "NP772A",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "N21972",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shandra Blacker, LMSW
• Cory Blad, LMSW
• Blair K. Garner, PA
• Kevin Blair, LMT,PTA
• Rebecca Nygaard Blair, RBT
• Scott M Blake, DDS
• Leslee Elyse Blanch, RD
• Lesli Blanchard, NNP
• Douglas U. Blank, MD
• Richard Alan Blatter, D.O.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.