Blake Erin Roseberry, FNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

28205992A Issued in IN

Practice address

1429 N 6TH St FL 4
Terre Haute, IN 47807-1019

Phone

(812) 242-3175

NPI assigned

Dec 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Blake Bennett Former name

Medicare fee-for-service enrollment

Enrolled in IN

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Union Associated Physicians Clinic, LLCGroup PAC ID 3375687437, 230 clinicians

Sullivan County Community HospitalGroup PAC ID 2466497482, 44 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Union Hospital Inc Hospital, Terre Haute, IN, CCN 150023
• Sullivan County Community Hospital Hospital, Sullivan, IN, CCN 151327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.roseberry.7@8793.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.

• Sullivan County Community Hospital

  • Clinic/Center
  • Sullivan, IN
  • NPI 1497363303
  Medicare reassignment Care Compare group NPD
• Union Associated Physicians Clinic, LLC

  • Family Medicine Physician
  • Terre Haute, IN
  • NPI 1891028379
  Medicare reassignment Care Compare group NPD
• Sullivan County Community Hospital

  • Critical Access Hospital Clinic/Center
  • Sullivan, IN
  • NPI 1487450698
  NPD
• Sullivan Family Practice, LLC

  • Family Medicine Physician
  • Sullivan, IN
  • NPI 1770502981
  NPD
• Union Associated Physicians Clinic LLC

  • Dermatology Physician
  • Terre Haute, IN
  • NPI 1407404940
  NPD
• Sullivan County Community Hospital

  • Critical Access Hospital
  • Sullivan, IN
  • NPI 1497759260
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sullivan County Community Hospital

  • Critical Access Hospital Clinic/Center
  • Sullivan, IN
  • NPI 1487450698
  Care Compare affiliation
• Sullivan County Community Hospital

  • Clinic/Center
  • Sullivan, IN
  • NPI 1497363303

  Hospital

  Care Compare affiliation
• Sullivan County Community Hospital

  • Critical Access Hospital
  • Sullivan, IN
  • NPI 1497759260
  Care Compare affiliation
• Union Hospital Inc.

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1619975331
  Care Compare affiliation
• Union Hospital, Inc

  • General Acute Care Hospital
  • Terre Haute, IN
  • NPI 1821859752
  Care Compare affiliation

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1932810751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1429 N 6TH ST FL 4",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071019",
            "telephone_number": "812-242-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 N 6TH ST FL 4",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478071019",
            "telephone_number": "812-242-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSEBERRY",
        "first_name": "BLAKE",
        "middle_name": "ERIN",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-13",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IN",
            "license": "28205992A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "28205992A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BLAKE",
            "last_name": "BENNETT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Nicole Rollins, MSN APRN FNP-C
• Celiea Deshae Rollins
• Trista Rompa, RBT
• Joseph Rosauer, ATC
• Sydney Rose
• Martin H Roseff, MD
• Roshel Chiropractic PC
• James L Roshel, D.C
• John A Roshel III, DDS
• Mary Arlena Roshel, D.D.S.

• Nurse Practitioner in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; 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.