Active NPI
Nicole Blank, PHARMD
- Pharmacist
- Media, PA
National Provider Identifier
1912598822
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP453322
- Practice address
- 301 East Baltimore Ave
Media, PA 19063 - Phone
- (610) 566-8400
- NPI assigned
- Feb 2, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP453322 | PA | Primary |
Addresses
Primary practice location
301 East Baltimore Ave
Media, PA 19063
Mailing address
2115 Spruce St Apt 3F
Philadelphia, PA 19103-4870
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RP453322 | Other | PA | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP453322 | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612224000000",
"number": "1912598822",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2115 SPRUCE ST APT 3F",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191034870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 EAST BALTIMORE AVE",
"city": "MEDIA",
"state": "PA",
"postal_code": "19063",
"telephone_number": "610-566-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLANK",
"first_name": "NICOLE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP453322",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "RP453322",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Media, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.