Amanda Sue Blake

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

334 Grandview Rd
Moundsville, WV 26041-5108

Phone

(681) 667-0397

NPI assigned

Dec 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1670371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1831800283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 GRANDVIEW RD",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260415108",
            "telephone_number": "681-667-0397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 GRANDVIEW RD",
            "city": "MOUNDSVILLE",
            "state": "WV",
            "postal_code": "260415108",
            "telephone_number": "681-667-0397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "AMANDA",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-07",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356607394",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125553494",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821206228",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Lynn Bell
• Donnie Alfred Bennett Jr.
• Crystal Berisford
• Tiara Nicole Bertrand
• India Rose Blackburn
• Beth Blake, CCC-SLP
• Crystal Lynn Blake
• Dennis Wayne Blake
• Donna Darlene Blake
• Margaret Blake

• Personal Care Attendant in Moundsville, WV
• Providers in Moundsville, WV by specialty
• Personal Care Attendant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; 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.