Carrie M. Blaser, APNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

2817 Issued in WI

Practice address

1200 W State St
Rockford, IL 61102-2112

Phone

(815) 490-1600

NPI assigned

Nov 16, 2006

Last updated

Feb 17, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266364800000",
    "number": "1750454765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611022112",
            "telephone_number": "815-490-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASER",
        "first_name": "CARRIE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2010-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "2817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41278800",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "000810765898",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bonnie Blakeley, L.C.P.C.
• Whitney Stana Blakely, LCSW MSW
• Daniel Blanck, PT, DPT
• Deanne Blanco, OTR/L
• Rachel A Bland, CNM
• Jennifer Ann Blaser, PTA
• Douglas Alan Blazer, PA
• Andrew Jay Blint, M.D.
• Kevin T Block Jr., PHARMD
• Bloom Therapeutics, LLC

• Pediatric Nurse Practitioner in Rockford, IL
• Providers in Rockford, IL by specialty
• Pediatric Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2010; 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.