Andrea Elizabeth Blalock
Individual provider Active NPI Nurse Practitioner · Meadville, MS
NPI 1831703255 · NPPES record last updated Dec 2, 2021
Key facts
- NPI
- 1831703255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 904369 (MS)
- Practice address
- 262 Olive St N
Meadville, MS 39653-3011 - Phone
- (601) 754-7655
- NPI assigned
- Sep 2, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 60.66 of 100
- Quality
- 26.46
- Improvement activities
- 40
- Cost
- 80.85
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS, LA
- 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 |
|---|---|---|---|---|
| I20211209002953 | MS | Practitioner - Nurse Practitioner | 3072903855 | Reassigns benefits to 3 organizations |
| I20240314001541 | LA | Practitioner - Nurse Practitioner | 3072903855 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904369 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Natchez HB Medical Services LLC | Nurse Practitioner | Current |
Accepting new patients |
| Jackson HB Medical Services LLC | Nurse Practitioner | Current |
Accepting new patients |
| Concordia Parish Hospital Service District Number One | Current |
Accepting new patients | |
| Keystone Medical Services of Ferriday, Inc. | Current |
Accepting new patients | |
| Concordia Parish Hospital Service District Number One | Current |
Accepting new patients | |
| Concordia Parish Hospital Service District Number One | Current |
Accepting new patients | |
| App of Mississippi Ed, LLC | Current |
Accepting new patients | |
| Concordia Parish Hospital Service District Number One | Past | Accepting new patients |
Locations
204 Serio Blvd
Ferriday, LA 71334
Phone (318) 757-0210
6569 Highway 84
Ste D
Ferriday, LA 71334
Phone (318) 719-3228
6569 Highway 84
Ridgecrest, LA 71334
Phone 3187576551605
1643 Carter St
Ste 1
Vidalia, LA 71373
Phone (318) 336-4444
1643 Carter St
Vidalia, LA 71373
Phone (318) 336-8707
150 Reynoir St
Biloxi, MS 39530
Phone (228) 432-7817
1030 River Oaks Dr
Jackson, MS 39232
Phone (601) 376-2165
1850 Chadwick Dr
Jackson, MS 39204
Phone (601) 376-1000
54 Sgt Prentiss Dr
Natchez, MS 39120
Phone (601) 443-2100
5121 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 436-6556
4728 Spottswood Ave
Memphis, TN 38117
Phone (901) 203-0080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Nurse Practitioner | 363L00000X | 904369 | MS | Yes |
Addresses
Primary practice location
262 Olive St N
Meadville, MS 39653-3011
Mailing address
PO Box 577
Meadville, MS 39653-0577
Phone (601) 754-7655
Other providers in Meadville, MS
- Apothecare LLC
- Jennifer Bonds Arnold
- Bigner Drugs LLC
- Boswell Regional Center
- Bradley Bowlin
- Susanne Michelle Bulington
- Brandon Jacob Butler
- Caring Hands Children'S Clinic II, LLC
All providers in Meadville, MS · Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 2, 2021. 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.