Individual provider Active NPI

Michael Jason Blocker, BSN RN

  • General Practice Registered Nurse
  • Lexington, KY
National Provider Identifier
1740809953
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
233925 Issued in SC
Practice address
1 St Hoseph Drive
Lexington, KY 40504
Phone
(859) 313-1000
NPI assigned
Apr 9, 2020
Last updated
Apr 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 233925 SC Primary

Addresses

Primary practice location

1 St Hoseph Drive
Lexington, KY 40504

Mailing address

5138 Lawrenceburg Rd
Harrison, OH 45030-9434
Phone (812) 584-3311

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
233925SCMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1740809953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5138 LAWRENCEBURG RD",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450309434",
            "telephone_number": "812-584-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ST HOSEPH DRIVE",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-313-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOCKER",
        "first_name": "MICHAEL",
        "middle_name": "JASON",
        "credential": "BSN RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-09",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "SC",
            "license": "233925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; 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.