Active NPI
Jennifer Blumenthal, CRNP
- Critical Care Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1659519627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pediatric Nurse Practitioner
- License
- SP010112
- Practice address
- 3400 Civic Center Blvd
Philadelphia, PA 19104-4306 - Phone
- (215) 590-7529
- NPI assigned
- Jan 29, 2009
- 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 |
|---|---|---|---|---|
| Critical Care Pediatric Nurse Practitioner | 363LP0222X | SP010112 | PA | Primary |
Addresses
Primary practice location
3400 Civic Center Blvd
Philadelphia, PA 19104-4306
Mailing address
1 Ticonderoga Dr
Bordentown, NJ 08505-2513
Phone (609) 324-7673
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP010112 | PA | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1659519627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 TICONDEROGA DR",
"city": "BORDENTOWN",
"state": "NJ",
"postal_code": "085052513",
"telephone_number": "609-324-7673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044306",
"telephone_number": "215-590-7529"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENTHAL",
"first_name": "JENNIFER",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0222X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics, Critical Care",
"state": "PA",
"license": "SP010112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.