Active NPI
Meghan Blaylock, AGACNP-BC
- Acute Care Nurse Practitioner
- Scottsbluff, NE
National Provider Identifier
1699296343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 112260
- Practice address
- 4021 Avenue B
Scottsbluff, NE 69361-4602 - Phone
- (308) 630-3711
- Fax
- (308) 630-3711
- NPI assigned
- Jul 3, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 112260 | NE | |
| Gerontology Nurse Practitioner | 363LG0600X | 112260 | NE | |
| Acute Care Nurse Practitioner | 363LA2100X | 112260 | NE | Primary |
Addresses
Primary practice location
4021 Avenue B
Scottsbluff, NE 69361-4602
Mailing address
1406 Avenue J
Scottsbluff, NE 69361-4148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170809003032 | NE | Practitioner - Nurse Practitioner | 3375814353 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Poudre Valley Medical Group LLC
Practice addresses (Care Compare)
2 W 42ND St
Scottsbluff, NE 69361-4669
Phone (308) 630-2626
3911 Ave B
Scottsbluff, NE 69361-4617
Phone (970) 482-3328
Hospital & facility affiliations
- Regional West Medical Center
- Poudre Valley Hospital
- Box Butte General Hospital
- Morrill County Community Hospital
- Community Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112260 | NE | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Regional West Physicians Clinic | Past | Accepting new patients |
Locations
2101 Box Butte Ave
Alliance, NE 69301
Phone (308) 762-6660
2 W 42nd St
Ste 2200
Scottsbluff, NE 69361
Phone (308) 630-2626
3911 Avenue B
Ste G200
Scottsbluff, NE 69361
Phone (308) 630-1355
3911 Avenue B
Ste 1100
Scottsbluff, NE 69361
Phone (308) 630-1355
3911 Avenue B
Scottsbluff, NE 69361
Phone (308) 630-2100
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 and National Provider Directory roles.
-
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
- Rural Health Clinic/Center
- Mitchell, NE
- NPI 1992703425
Hospital & facility affiliations 19
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": "1499040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1499040000000",
"number": "1699296343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 AVENUE J",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4021 AVENUE B",
"city": "SCOTTSBLUFF",
"state": "NE",
"postal_code": "693614602",
"telephone_number": "308-630-3711",
"fax_number": "308-630-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAYLOCK",
"first_name": "MEGHAN",
"credential": "AGACNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-03",
"last_updated": "2017-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NE",
"license": "112260",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "NE",
"license": "112260",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "NE",
"license": "112260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsbluff, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2017; 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.