Kayla Blaker, NP

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

SP022589 Issued in PA

Practice address

1401 S 31St St FL 2
Philadelphia, PA 19146-3506

Phone

(888) 296-4742

NPI assigned

Nov 2, 2020

Last updated

Nov 18, 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Greater Philadelphia Health Action Inc.

  dba GPHA Woodland Ave. Behavioral Healthcare

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1205140902
  Medicare reassignment NPD
• Greater Philadelphia Health Action Inc.

  dba GPHA-Frankford Avenue Health Center

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1659325652

  Family Medicine

  NPD
• Greater Philadelphia Health Action, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1275151607
  NPD

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1871194456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W RITNER ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191454324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506",
            "telephone_number": "888-296-4742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 W Ritner St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191454324",
            "country_code": "US",
            "telephone_number": "215-336-2145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKER",
        "first_name": "KAYLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "SP022589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Victor Blake, MD
• James Blake
• Melna Blake
• James Blakely, MPT
• Garrett Dylan Blaker, DNP, APRN
• Veronica Blamasah, MHS, PA-C
• Bryan Matthew Blanchard, CRNP
• Erica Blanchard
• Annabelle Blanchet, MD
• Noelia Blanco

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.