Individual provider Active NPI

Kristen Shiela Blazey, LPN

  • Licensed Practical Nurse
  • Apalachin, NY
National Provider Identifier
1821264151
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
245238-1 Issued in NY
Practice address
513 Barton Rd
Apalachin, NY 13732-1929
Phone
(607) 625-3629
NPI assigned
May 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 245238-1 NY Primary

Addresses

Primary practice location

513 Barton Rd
Apalachin, NY 13732-1929

Mailing address

513 Barton Rd
Apalachin, NY 13732-1929
Phone (607) 625-3629

Other identifiers 1

IdentifierTypeStateIssuer
01870199MedicaidNY

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

State licenses

LicenseStateTypeSpecialty
245238-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1821264151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BARTON RD",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137321929",
            "telephone_number": "607-625-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BARTON RD",
            "city": "APALACHIN",
            "state": "NY",
            "postal_code": "137321929",
            "telephone_number": "607-625-3629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEY",
        "first_name": "KRISTEN",
        "middle_name": "SHIELA",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "245238-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01870199",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apalachin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.