Jillian Clark Blaisdell

Primary specialty

AudiologistTaxonomy code 231H00000X

License

AUD00242 Issued in RI

Practice address

148 W River St Ste 2a
Providence, RI 02904-2615

Phone

(401) 616-1719

Fax

(401) 727-1979

NPI assigned

Jul 26, 2018

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 RI

Enrollment records 1

Specialty

Qualified Audiologist

Education

University of Connecticut School of Medicine, 2018

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Ri Ear Nose & Throat Physicians Inc.

  • Otolaryngology Physician
  • Providence, RI
  • NPI 1093861049
  Medicare reassignment NPD

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1881171403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 2A",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "401-616-1719",
            "fax_number": "401-727-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 2A",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "401-616-1719",
            "fax_number": "401-727-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAISDELL",
        "first_name": "JILLIAN",
        "middle_name": "CLARK",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-26",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "RI",
            "license": "AUD00242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natasha Blackadar, MED
• Rachael Keir Blackman, M.D., PH.D.
• Blackstone Massage Therapy Center
• Adrien Jean Blaine
• Erin Carpenter Blais, NP
• Christopher Blake
• Dawna A. Blake, M.D.
• Douglas Blake, MD
• Megan Blake
• Michael Scott Blakeslee, PA-C

• Audiologist in Providence, RI
• Providers in Providence, RI by specialty
• Audiologist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.