Mysti Blizzard, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26NJ00765900 Issued in NJ

Practice address

1505 W Sherman Ave Ste 101
Vineland, NJ 08360-7059

Phone

(856) 696-9550

NPI assigned

Nov 8, 2017

Last updated

Nov 8, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Community Health Care, Inc.Group PAC ID 9335040419, 126 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Health Care, Inc.

  dba CompleteCare Health Network

  • Federally Qualified Health Center (FQHC)
  • Bridgeton, NJ
  • NPI 1700816816
  Medicare reassignment Care Compare group NPD
• Southern Oncology Hematology Assoc

  • Specialist
  • Vineland, NJ
  • NPI 1144211087
  Medicare reassignment NPD
• Shore Memorial Hospital

  dba SMH Professional Services

  • Hematology & Oncology Physician
  • Somers Point, NJ
  • NPI 1689795338
  Medicare reassignment
• Community Health Care, Inc.

  dba CompleteCare Health Network

  • Federally Qualified Health Center (FQHC)
  • Williamstown, NJ
  • NPI 1194568303
  NPD

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510099200000",
    "number": "1982117339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE STE 101",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-696-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W SHERMAN AVE STE 101",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083607059",
            "telephone_number": "856-696-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIZZARD",
        "first_name": "MYSTI",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00765900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BJ's Wholesale Club Inc.
• Gina Black, OT
• Kyle Blalock, PHARMD
• Phillip Blandino
• Eric Pollack Blazar, MD
• Suzanne Blizzard, OT
• David H Blom, DO
• Blooming Within Counseling LLC (Blooming Within Counseling)
• Prasanthi Bobba, D.D.S
• Ezra Ralph Bobo, M.D.

• Family Nurse Practitioner in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Family Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.