Active NPI
Ann Elizabeth Blackwell, R.N,
- Maternal Newborn Registered Nurse
- Bloomington, IN
National Provider Identifier
1811235328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Maternal Newborn Registered Nurse
- License
- 28158668A
- Practice address
- 505 W San Juan Dr
Bloomington, IN 47403-4385 - Phone
- (812) 320-1852
- NPI assigned
- Jan 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Maternal Newborn Registered Nurse | 163WM0102X | 28158668A | IN | Primary |
Addresses
Primary practice location
505 W San Juan Dr
Bloomington, IN 47403-4385
Mailing address
505 W San Juan Dr
Apt/Suite
Bloomington, IN 47403-4385
Phone (812) 320-1852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28158668A | IN | MD | Maternal Newborn Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358467200000",
"number": "1811235328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W SAN JUAN DR",
"address_2": "APT/SUITE",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474034385",
"telephone_number": "812-320-1852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 W SAN JUAN DR",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474034385",
"telephone_number": "812-320-1852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACKWELL",
"first_name": "ANN",
"middle_name": "ELIZABETH",
"credential": "R.N,",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-18",
"last_updated": "2013-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0102X",
"taxonomy_group": "",
"desc": "Registered Nurse, Maternal Newborn",
"state": "IN",
"license": "28158668A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.