Victoria Blake

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN5238837 Issued in FL

Practice address

2300 Congress St
Portland, ME 04102-1908

Phone

(207) 221-2292

NPI assigned

Jul 13, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Community Physicians PC

  • Methadone Clinic
  • Portland, ME
  • NPI 1316242209
  NPD (past)
• Merrimack River Medical Services, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portland, ME
  • NPI 1912233826
  NPD (past)

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1801468533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62 WAINWRIGHT CIR W",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041062522",
            "telephone_number": "850-529-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CONGRESS ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041021908",
            "telephone_number": "207-221-2292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5238837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Vblake@hcrcenters.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2300 Congress St",
            "city": "Portland",
            "state": "ME",
            "country_code": "US",
            "postal_code": "041021908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Oaklin Blaisdell, LCSW
• Hayley Marie Blaise, CRNA
• Jeffrey Blake, LCSW
• Lori E B Blake
• Rachael Y Blake, MD
• Paul Blakeslee, MS, RD-AP, LD, CNSC
• Holly Blanchard, LCSW
• Aaron Blanchette, PSY.D.
• Jennifer A Blanchette, PSYD
• Kimberly M. Blaney, LCPC

• All providers in Portland, ME
• Licensed Practical Nurse in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.