Individual provider Active NPI

Kristin McGinnis Blonk, DNP, CRNA

  • Certified Registered Nurse Anesthetist
  • Rocky Mount, NC
National Provider Identifier
1780109041
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
113603 Issued in NC
Practice address
2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone
(252) 962-3627
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 240738 NC
Certified Registered Nurse Anesthetist 367500000X 113603 NC Primary

Addresses

Primary practice location

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237

Mailing address

3612 Horsemint TRL
Zebulon, NC 27597-8909
Phone (828) 612-8226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031000244 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961778337 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nash Hospitals IncGroup PAC ID 4284521568, 39 clinicians

Practice addresses (Care Compare)

2460 Curtis Ellis Dr
Rocky Mount, NC 27804-2237
Phone (252) 962-8000

Hospital & facility affiliations

  • Unc Health Nash Hospital, Rocky Mount, NC, CCN 340147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
113603NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nash Hospitals Inc CurrentSince Sep 25, 2017 Accepting new patients
Nash Hospitals Inc Nurse Anesthetist, Certified Registered CurrentSince Sep 25, 2017 Accepting new patients

Locations

2460 Curtis Ellis Dr
Rocky Mount, NC 27804
Phone (252) 443-8199

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551225600000",
    "number": "1780109041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 HORSEMINT TRL",
            "city": "ZEBULON",
            "state": "NC",
            "postal_code": "275978909",
            "telephone_number": "828-612-8226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 CURTIS ELLIS DR",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278042237",
            "telephone_number": "252-962-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLONK",
        "first_name": "KRISTIN",
        "middle_name": "MCGINNIS",
        "credential": "DNP, CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2019-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "240738",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "113603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.