Individual provider Active NPI

Kamaria Liani Blakes, FNP-C

  • Family Nurse Practitioner
  • Baton Rouge, LA
National Provider Identifier
1811496730
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP09778 Issued in LA
Practice address
5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone
(225) 765-4050
Fax
(225) 765-4046
NPI assigned
Feb 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP09778 LA Primary

Addresses

Primary practice location

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375

Mailing address

17051 Richmond Dr
Prairieville, LA 70769-4860
Phone (225) 588-9477

Other practice location 1

19100 Dr John Lambert Dr
Hammond, LA 70403-0922
Phone (985) 467-0896

Other practice location 2

1125 W Highway 30
Gonzales, LA 70737-5004
Phone (225) 621-2975

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kblakes841818@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191106000716 LA Practitioner - Nurse Practitioner 4789916032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7777 Hennessy Blvd
Suite 409
Baton Rouge, LA 70808-4365
Phone (225) 765-5864

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP09778LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Oct 28, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC Nurse Practitioner Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Oct 28, 2019 Accepting new patients
Louisiana Stat Care LLC Past Accepting new patients

Locations

7777 Hennessy Blvd
Ste 701
Baton Rouge, LA 70808
Phone (225) 765-5864

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

7777 Hennessy Blvd
Ste 409
Baton Rouge, LA 70808
Phone (225) 765-1765

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

Interoperability endpoints

  • Direct secure messaging: kblakes841818@direct.casso.us.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1811496730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17051 RICHMOND DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707694860",
            "telephone_number": "225-588-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 HENNESSY BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084375",
            "telephone_number": "225-765-4050",
            "fax_number": "225-765-4046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19100 Dr John Lambert Dr",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704030922",
            "country_code": "US",
            "telephone_number": "985-467-0896",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1125 W Highway 30",
            "address_purpose": "LOCATION",
            "city": "Gonzales",
            "state": "LA",
            "postal_code": "707375004",
            "country_code": "US",
            "telephone_number": "225-621-2975",
            "fax_number": "225-621-2931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKES",
        "first_name": "KAMARIA",
        "middle_name": "LIANI",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-06",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kblakes841818@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kblakes841818@direct.casso.us.com",
            "address_1": "5000 Hennessy Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epihosted.com/FHIRPoxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5000 Hennessy Blvd",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "708084375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.