Individual provider Active NPI

Tina Blowers, NP

  • Adult Health Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1720648686
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
71009019 Issued in IN
Practice address
2121 Lake Ave
Fort Wayne, IN 46805-5100
Phone
(260) 426-5431
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 71009019 IN Primary
Gerontology Nurse Practitioner 363LG0600X 71009019A IN

Addresses

Primary practice location

2121 Lake Ave
Fort Wayne, IN 46805-5100

Mailing address

2121 Lake Ave
Fort Wayne, IN 46805-5100

Other names 1

  • Tina Hoover Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71009019INMDAdult Health Nurse Practitioner
71009019AINMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lima Memorial Joint Operating Company Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tina.blowers@398008301912068.direct.elationemr.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1720648686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LAKE AVE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055100",
            "telephone_number": "260-426-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOWERS",
        "first_name": "TINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71009019",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71009019A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "HOOVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.