Bridgette C Blain, P.A. - C.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1501057 Issued in KS

Practice address

20333 W 151St St
Olathe, KS 66061-5350

Phone

(913) 791-4357

Fax

(913) 791-4435

NPI assigned

Jul 7, 2006

Sex

Female

Sole proprietor

No

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)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1790717122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 716",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662010716",
            "telephone_number": "913-791-4357",
            "fax_number": "913-791-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20333 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660615350",
            "telephone_number": "913-791-4357",
            "fax_number": "913-791-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIN",
        "first_name": "BRIDGETTE",
        "middle_name": "C",
        "credential": "P.A. - C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "1501057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200371000A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC",
            "identifier": "43346012",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Birkelbach Cowden, MS
• Roshan Bisarya, MD
• Dawn Michele Bishop, APRN
• Cecily E Blackman, LSCSW
• Stephanie Marie Blackman, APRN
• Tessa Blair
• Cameon Michelle Blake, DC
• Patsy Ruth Blalock, LSCSW
• Cayla Bland, PH.D.
• Alison Blevins, MD

• Physician Assistant in Olathe, KS
• Providers in Olathe, KS by specialty
• Physician Assistant in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.