Jamie Blair
Individual provider Active NPI Family Nurse Practitioner · Bowling Green, KY
NPI 1821779489 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1821779489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 4007596 (KY)
- Practice address
- 484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914 - Phone
- (270) 781-5111
- NPI assigned
- Jul 27, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Graves Gilbert Clinic PLLC
Practice addresses (Care Compare)
484 Golden Autumn Way
Suite 201
Bowling Green, KY 42103-6914
Phone (270) 781-5111
Hospital & facility affiliations
- The Medical Center (Bowling Green)
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230821002801 | KY | Practitioner - Nurse Practitioner | 6002278108 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graves Gilbert Clinic PLLC | Current |
Accepting new patients | |
| Graves Gilbert Clinic PLLC | Current |
Accepting new patients |
Locations
484 Golden Autumn Way
Ste 201
Bowling Green, KY 42103
Phone (270) 783-3300
201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229
102C Physicians Blvd
Glasgow, KY 42141
Phone (270) 651-2433
Interoperability endpoints
- jamieblair@ggc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Family Nurse Practitioner | 363LF0000X | 4007596 | KY | Yes |
Addresses
Primary practice location
484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914
Mailing address
201 Park St
Bowling Green, KY 42101-1708
Other providers in Bowling Green, KY
- Michael Bjoralt
- Laura Black
- Michelle R Black
- Logan Blackmon
- Cassandra Collette Blackwell
- Kevin R Blalock
- Autumn Bland
- Shannon G Blandford
- Alyzea Blankenship
- Kristin Marie Blankenship
All providers in Bowling Green, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.