Heather Ann Blair, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

085.004864 Issued in IL

Practice address

122 S 77TH St
Omaha, NE 68114-4577

Phone

(402) 934-4535

Fax

(402) 934-5939

NPI assigned

Nov 15, 2013

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

• Heather Ann Chen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1952731754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 S 77TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144577",
            "telephone_number": "402-934-4535",
            "fax_number": "402-934-5939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S 77TH ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144577",
            "telephone_number": "402-934-4535",
            "fax_number": "402-934-5939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "HEATHER",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-15",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "1982",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "085.004864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CHEN",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa A Bladt, MD
• Lisa Ann Blagdon
• Rachel Ann Blaine, BSW
• John Blaiotta
• Kristin Margaret Blair-Beals, PLDAC
• Jordan Blair
• Julia Michelle Blair, RN
• Kristin M Blair, MOT OTR/L
• Kristin Marie Blair
• Amyiia Blake

• Family Medicine Physician in Omaha, NE
• Providers in Omaha, NE by specialty
• Family Medicine Physician in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.