Katherine E Blake, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5019185 Issued in NC

Practice address

2002 S Glenburnie Rd Ste 100
New Bern, NC 28562-5229

Phone

(252) 631-5188

NPI assigned

Feb 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Med First Immediate Care and Family Practice PAGroup PAC ID 0446332720, 94 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katherine.blake.1@1905.direct.athenahealth.com

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.

• Med First Immediate Care & Family Practice, PA

  • Family Medicine Physician
  • Jacksonville, NC
  • NPI 1053503763
  Medicare reassignment Care Compare group NPD
• Dwic of Tampa Bay, Inc

  • Urgent Care Clinic/Center
  • Hudson, FL
  • NPI 1598132490
  NPD (past)

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

{
    "created_epoch": "1360022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1912246331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 S GLENBURNIE RD STE 100",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625229",
            "telephone_number": "252-631-5188",
            "fax_number": "815-729-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 S GLENBURNIE RD STE 100",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625229",
            "telephone_number": "252-631-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-05",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009946",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209009946",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5019185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Wynne Black, NP
• Sandra G Blackburn, CNM
• Zoi Blackwell
• Kayla Blair
• Robert Gillespie Blair Jr., M.D.
• Sally Blakley
• Areaonia Blalock, LCMHC-A, LCAS-A
• Ronald Dean Blanchard, LCAS, LCMHCA
• Zachary Blank, DPT
• Janice Reyburn Blann, NP

• Family Nurse Practitioner in New Bern, NC
• Providers in New Bern, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.