Active NPI
Paige Blumenthal, CRNP
- Pediatric Nurse Practitioner
- Philadelphia, PA
National Provider Identifier
1972013118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- SP017745
- Practice address
- 6608 Castor Ave
Philadelphia, PA 19149-2120 - Phone
- (215) 342-7710
- NPI assigned
- Oct 2, 2017
- 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | SP017745 | PA | Primary |
Addresses
Primary practice location
6608 Castor Ave
Philadelphia, PA 19149-2120
Mailing address
630 S American St
Philadelphia, PA 19147-2304
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
| License | State | Type | Specialty |
|---|---|---|---|
| SP017745 | PA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Castor Pediatrics PC | Past | Accepting new patients | |
| E&M Healthcare | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Philadelphia, PA
- NPI 1730118712
-
- Pediatrics Physician
- Phila, PA
- NPI 1437781853
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506902400000",
"number": "1972013118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 S AMERICAN ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191472304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6608 CASTOR AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191492120",
"telephone_number": "215-342-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUMENTHAL",
"first_name": "PAIGE",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-02",
"last_updated": "2017-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "SP017745",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.