Gregory Alen Blake Jr., MSN, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.023765 Issued in OH

Practice address

1636 Tunis Dr
Harrison, OH 45030-2834

Phone

(513) 265-3449

NPI assigned

Oct 15, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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

{
    "created_epoch": "1539561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1780150060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 TUNIS DR",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302834",
            "telephone_number": "513-265-3449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 TUNIS DR",
            "city": "HARRISON",
            "state": "OH",
            "postal_code": "450302834",
            "telephone_number": "513-265-3449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "GREGORY",
        "middle_name": "ALEN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-15",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.023765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Berning
• Beyond the Label
• Jeffrey P Biddle, RPH
• Melissa Biedenharn, RPH
• Cassidy Bischoff, M.A. CCC-SLP
• Jazmin C. Blankman, O.D.
• Jane A Blinzler, MD
• Elizabeth Feldhaus Boettcher, RN
• Borrego Dialysis LLC
• Audrey Bray

• Family Nurse Practitioner in Harrison, OH
• Providers in Harrison, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.