Keith Loren Blair, APRN-CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95026892 Issued in CA

Practice address

1441 Florida Ave
Modesto, CA 95350-4404

Phone

(209) 576-3525

NPI assigned

Aug 25, 2023

Last updated

Oct 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family First Medical Care a Professional Corporation

  • Multi-Specialty Clinic/Center
  • Modesto, CA
  • NPI 1689066029
  Medicare reassignment NPD
• Pulmonary & Critical Care Associates of Modesto Inc

  • Pulmonary Disease Physician
  • Modesto, CA
  • NPI 1669849394
  Medicare reassignment
• Family First Medical Care a Professional Corporation

  • Durable Medical Equipment & Medical Supplies
  • Modesto, CA
  • NPI 1699639070
  NPD

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696636800000",
    "number": "1710762091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "405-564-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 FLORIDA AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504404",
            "telephone_number": "209-576-3525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1317 Oakdale Rd Ste 440",
            "address_purpose": "LOCATION",
            "city": "Modesto",
            "state": "CA",
            "postal_code": "953553364",
            "country_code": "US",
            "telephone_number": "209-522-3362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "KEITH",
        "middle_name": "LOREN",
        "name_prefix": "Mr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-10-07",
        "certification_date": "2023-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95026892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Black VIII
• Stacey Black
• Janice Blackmon
• James Luke Blackwell
• Brook Blair
• Ruth Blair, RD
• Seth Hayden Blair
• Vivian Elizabeth Flora Blair
• Blake D. Alexander, MD PC
• Kiley Blake

• Nurse Practitioner in Modesto, CA
• Providers in Modesto, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2023; 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.