Susan Blair, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

230074 Issued in TX

Practice address

11801 South Fwy
Suite 338
Burleson, TX 76028-7021

Phone

(817) 568-5485

Fax

(817) 568-5434

NPI assigned

Sep 21, 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

Practice roles

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.

• Physicians and Allied Health Professionals Group, PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1528011814
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416441600000",
    "number": "1790883684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "address_2": "SUITE 338",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-568-5485",
            "fax_number": "817-568-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11801 SOUTH FWY",
            "address_2": "SUITE 338",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287021",
            "telephone_number": "817-568-5485",
            "fax_number": "817-568-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "SUSAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2014-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "230074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103294803",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103294801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bir JV LLP
• Hisham Bismar, M.D.
• Mike M Bismar, MD
• Esther Biswa, LVN
• Carol Lynn Black
• Meagan Rene Blanks, MSN-FNP-C, RNFA
• Sade Blanks, PTA
• Bloomer Ventures LLC
• Christal Bloomer
• BLTX Emergency Physicians PLLC

• Family Nurse Practitioner in Burleson, TX
• Providers in Burleson, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.