Olivia Keelin Blake, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP033283 Issued in PA

Practice address

169 N Pennsylvania Ave
Wilkes Barre, PA 18701-3603

Phone

(570) 346-8147

Fax

(570) 230-0013

NPI assigned

Sep 8, 2025

Sex

Female

Sole proprietor

Yes

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• The Wright Center Medical Group

  • Internal Medicine Physician
  • Scranton, PA
  • NPI 1194739979
  Medicare reassignment NPD
• The Wright Center Medical Group

  • Federally Qualified Health Center (FQHC)
  • Scranton, PA
  • NPI 1649836941
  NPD

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1902787997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013603",
            "telephone_number": "570-346-8147",
            "fax_number": "570-230-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N PENNSYLVANIA AVE",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187013603",
            "telephone_number": "570-346-8147",
            "fax_number": "570-230-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "OLIVIA",
        "middle_name": "KEELIN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP033283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roman Bish, M.D.
• Anthony Black, LCSW
• Erin Leigh Black, PA-C
• Samantha Black, PT, DPT
• Michaela Blackwell, AUD
• William B. Blannett, CRNA
• Lucas Blaszyk, PT
• Louis C Blaum, MD
• Aleaha Marie Blazick, PA-C
• Martin D Blidner, MD

• Nurse Practitioner in Wilkes Barre, PA
• Providers in Wilkes Barre, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.