Individual provider Active NPI

Faye H Blaszak, NP

  • Acute Care Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1932425139
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4179 Issued in SC
Practice address
Bon Secours Neurology
801 Roper Creek Drive
Greenville, SC 29615-6938
Phone
(864) 516-1170
Fax
(877) 249-9483
NPI assigned
Apr 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4179 SC Primary

Addresses

Primary practice location

Bon Secours Neurology
801 Roper Creek Drive
Greenville, SC 29615-6938

Mailing address

PO Box 743294
Atlanta, GA 30374-3294
Phone (864) 797-6303

Other practice location 1

200 Patewood Dr
Suite B350
Greenville, SC 29615-3593
Phone (864) 454-4500

Other practice location 2

109 Doctors Dr
Greenville, SC 29605-5608
Phone (864) 797-7150

Other identifiers 2

IdentifierTypeStateIssuer
NP1604MedicaidSC
APPROVEDMedicaidSC

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4179SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Physician Services Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1932425139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743294",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743294",
            "telephone_number": "864-797-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BON SECOURS NEUROLOGY",
            "address_2": "801 ROPER CREEK DRIVE",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156938",
            "telephone_number": "864-516-1170",
            "fax_number": "877-249-9483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Patewood Dr",
            "address_2": "Suite B350",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296153593",
            "country_code": "US",
            "telephone_number": "864-454-4500",
            "fax_number": "864-454-4505",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Doctors Dr",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296055608",
            "country_code": "US",
            "telephone_number": "864-797-7150",
            "fax_number": "864-797-7155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLASZAK",
        "first_name": "FAYE",
        "middle_name": "H",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "4179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1604",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "APPROVED",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.