Individual provider Active NPI

Elizabeth Marie Blevins, LPN

  • Licensed Practical Nurse
  • Clarksburg, OH
National Provider Identifier
1962695940
Registry record updated Aug 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN091883 Issued in OH
Practice address
3336 Putnam Rd
Clarksburg, OH 43115
Phone
(740) 993-2302
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN091883 OH Primary

Addresses

Primary practice location

3336 Putnam Rd
Clarksburg, OH 43115

Mailing address

3336 Putnam Rd
Clarksburg, OH 43115
Phone (740) 993-2302

Other identifiers 1

IdentifierTypeStateIssuer
2705693MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
PN091883OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187740800000",
    "number": "1962695940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 PUTNAM RD",
            "city": "CLARKSBURG",
            "state": "OH",
            "postal_code": "43115",
            "telephone_number": "740-993-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 PUTNAM RD",
            "city": "CLARKSBURG",
            "state": "OH",
            "postal_code": "43115",
            "telephone_number": "740-993-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN091883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2705693",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2007; 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.