Individual provider Active NPI

Sheena Blocker, FNP-C

  • Nurse Practitioner
  • Pocatello, ID
National Provider Identifier
1659953917
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
67539 Issued in ID
Practice address
2850 Olympus Dr
Pocatello, ID 83201-2271
Phone
(208) 239-2273
Fax
(208) 239-3677
NPI assigned
Apr 26, 2021
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 67539 ID Primary

Addresses

Primary practice location

2850 Olympus Dr
Pocatello, ID 83201-2271

Mailing address

2850 Olympus Dr
Pocatello, ID 83201-2271
Phone (208) 239-2273

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220307001667 ID Practitioner - Nurse Practitioner 0941694020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PHS Ambulatory Services LLCGroup PAC ID 6507213402, 6 clinicians

Practice addresses (Care Compare)

2850 Olympus Dr
Pocatello, ID 83201-2271
Phone (208) 239-2273

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
67539IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PHS Ambulatory Services LLC CurrentSince Sep 14, 2023 Accepting new patients
BMH, Inc. PastSince Apr 1, 2022 Accepting new patients
BMH, Inc. PastSince Apr 1, 2022 Accepting new patients

Locations

2850 Olympus Dr
Pocatello, ID 83201
Phone (208) 239-2273

Interoperability endpoints

  • Direct secure messaging: sblocker264568@ahs.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1659953917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012271",
            "telephone_number": "208-239-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012271",
            "telephone_number": "208-239-2273",
            "fax_number": "208-239-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "SHEENA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "67539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.