Active NPI
Emily Blake
- Administrator Registered Nurse
- New Haven, IN
National Provider Identifier
1730019340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Administrator Registered Nurse
- License
- 28265752A
- Practice address
- 11165 State Road 37 E
New Haven, IN 46774-9770 - Phone
- (260) 415-4871
- NPI assigned
- May 23, 2026
- Last updated
- May 23, 2026
- 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 |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 28265752A | IN | Primary |
Addresses
Primary practice location
11165 State Road 37 E
New Haven, IN 46774-9770
Mailing address
5124 Cork Tree CV
Fort Wayne, IN 46825-0039
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 |
|---|---|---|---|
| 28265752A | IN | MD | Administrator Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1779494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779494400000",
"number": "1730019340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5124 CORK TREE CV",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468250039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11165 STATE ROAD 37 E",
"city": "NEW HAVEN",
"state": "IN",
"postal_code": "467749770",
"telephone_number": "260-415-4871"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-23",
"last_updated": "2026-05-23",
"certification_date": "2026-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "163WA2000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Administrator",
"state": "IN",
"license": "28265752A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.