Audrey Blaine, F.N.P

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

21933 Issued in CA

Practice address

751 Medical Center CT
Chula Vista, CA 91911-6617

Phone

(619) 502-5800

NPI assigned

Apr 5, 2013

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1447281936
  Medicare reassignment NPD
• Family Health Centers of San Diego Inc

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
  • NPI 1184982159
  NPD
• Family Health Centers of San Diego, Inc

  • Federally Qualified Health Center (FQHC)
  • Escondido, CA
  • NPI 1356178180
  NPD

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630713600000",
    "number": "1629311964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 NORTHRIM CT UNIT 258",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921117338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 MEDICAL CENTER CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919116617",
            "telephone_number": "619-502-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAINE",
        "first_name": "AUDREY",
        "credential": "F.N.P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-05",
        "last_updated": "2021-09-04",
        "certification_date": "2021-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "21933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Birth Roots Inc
• Keith Joseph Biscotti, D.C.
• Jean Loup Bitterlin
• Gary Leon Blackburn, M.S.P.T.
• Kimberly Blackman
• William Anthony Anderson Blair Jr., PH.D.
• Racquel Blancaflor
• Kasandra Edith Blanco
• Blanca Blas, RDH
• Eryn Blase

• Family Nurse Practitioner in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.