Andrea Elizabeth Blalock

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

904369 Issued in MS

Practice address

262 Olive St N
Meadville, MS 39653-3011

Phone

(601) 754-7655

NPI assigned

Sep 2, 2020

Last updated

Dec 2, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

60.66 of 100Reported as group

Quality

26.46

Improvement activities

40

Cost

80.85

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• App of Mississippi Ed, LLC

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1730687740
  Medicare reassignment NPD
• Jackson HB Medical Services LLC

  dba Merit Health Central

  • Emergency Medicine Physician
  • Jackson, MS
  • NPI 1184305856

  Nurse Practitioner

  Medicare reassignment NPD
• Natchez HB Medical Services LLC

  dba Merit Health Natchez

  • Emergency Medicine Physician
  • Natchez, MS
  • NPI 1770264459

  Nurse Practitioner

  Medicare reassignment NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Critical Access Hospital
  • Ferriday, LA
  • NPI 1144227935
  Medicare reassignment NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical Ferriday Clinic

  • Rural Health Clinic/Center
  • Ferriday, LA
  • NPI 1679513600
  Medicare reassignment NPD
• Keystone Medical Services of Ferriday, Inc.

  • Emergency Medicine Physician
  • Ferriday, LA
  • NPI 1215704754
  Medicare reassignment NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical

  • Critical Access Hospital
  • Ferriday, LA
  • NPI 1275852303
  NPD
• Concordia Parish Hospital Service District Number One

  dba Trinity Medical Vidalia Clinic

  • Rural Health Clinic/Center
  • Vidalia, LA
  • NPI 1780190322
  NPD (past)

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1831703255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396530577",
            "telephone_number": "601-754-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 OLIVE ST N",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396533011",
            "telephone_number": "601-754-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "ANDREA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "904369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Apothecare LLC
• Jennifer Bonds Arnold, P.T.
• Bigner Drugs LLC (Super Save Drugs)
• Boswell Regional Center
• Bradley Bowlin, M.D.
• Susanne Michelle Bulington
• Brandon Jacob Butler, LPTA
• Caring Hands Children's Clinic II, LLC

• Nurse Practitioner in Meadville, MS
• Providers in Meadville, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.