Brian G Blake, APRN, FNP-BC, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.022503 Issued in IL

Practice address

8135 Calumet Ave
Munster, IN 46321-1701

Phone

(219) 513-2000

NPI assigned

Dec 10, 2020

Last updated

Feb 8, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

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.

• The Methodist Hospitals, Inc

  dba Methodist Northlake Physicians

  • Internal Medicine Physician
  • Gary, IN
  • NPI 1720290349
  NPD (past)

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1649876046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15604 ROB ROY DR",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522738",
            "telephone_number": "773-771-8197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8135 CALUMET AVE",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211701",
            "telephone_number": "219-513-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15604 Rob Roy Dr",
            "address_purpose": "LOCATION",
            "city": "Oak Forest",
            "state": "IL",
            "postal_code": "604522738",
            "country_code": "US",
            "telephone_number": "773-771-8197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "BRIAN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "APRN, FNP-BC, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.022503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Biggerstaff, FNP-BC
• Beata Bigos
• Carolina Binciguerra Burns, PHARMD
• Bionic Prosthetics and Orthotics Group LLC
• Yolla Blair
• Jessica Marie Blandford
• Karen Bledsoe
• Adrianne Lyn Blevins, FNP-C
• Amber Dawn Bodak, LCSW, LSW, MSW,
• Aaron J Boileau, MS, LMHC-A

• Family Nurse Practitioner in Munster, IN
• Providers in Munster, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.