KACY BLADERGROEN (NPI# 1508007329) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508007329 |
| Entity Type | Individual |
| Full Name | KACY BLADERGROEN |
| Credential | A.R.N.P. |
| Practice Address |
2100 Nebraska Ave Suite 113 Fort Pierce FL 34950-4704 |
| Practice Telephone | 7724600321 |
| Practice Fax Number | 7724600332 |
| Mailing Telephone | 7724600321 |
| Mailing Fax Number | 7724600332 |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2011-11-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
9264276 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2100 NEBRASKA AVE SUITE 113 |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34950-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992782577 | Ziad M Marjieh | Internal Medicine | 2100 Nebraska Ave, Suite 105, Fort Pierce, FL 34950-4704 | 2005-12-27 |
| 1942780895 | Omega Health Center, Inc. | Health Educator | 2100 Nebraska Ave, Fort Pierce, FL 34950-4704 | 2018-08-20 |
| 1972928984 | Suzan E Zimmer, D.o., Pa | Family Medicine | 2100 Nebraska Ave, Suite 111, Fort Pierce, FL 34950-4704 | 2014-02-27 |
| 1255685251 | Hem Onc Associates of The Treasure Coast, Pa | Internal Medicine | 2100 Nebraska Ave, Suite 107, Fort Pierce, FL 34950-4704 | 2012-10-30 |
| 1720376940 | Jessica Marie Hamilton Tedder | Nurse Practitioner | 2100 Nebraska Ave, Suite 113, Fort Pierce, FL 34950-4704 | 2011-07-21 |
| 1942530951 | Dwight G. A. Dawkins, Md, Pa | Family Medicine | 2100 Nebraska Ave, Suite 201, Fort Pierce, FL 34950-4831 | 2010-01-14 |
| 1326239336 | Sarah Lynn Testa | Nurse Practitioner | 2100 Nebraska Ave, Suite 201, Fort Pierce, FL 34950-4704 | 2007-08-05 |
| 1386724169 | Lawnwood Cardiovascular Surgery LLC | Internal Medicine | 2100 Nebraska Ave, Suite 202, Fort Pierce, FL 34950-4704 | 2006-10-16 |
| 1740297332 | Terence Peter Downing | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2100 Nebraska Ave, Suite 202, Fort Pierce, FL 34950-4704 | 2006-08-03 |
| 1700893310 | Pamela Roberts | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2100 Nebraska Ave, Suite 202, Fort Pierce, FL 34950-4704 | 2006-08-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659853018 | New Day Counseling & Wellness, LLC | Clinic/Center | 130 S Indian River Drive Suite 202, Fort Pierce, FL 34950 | 2018-09-03 |
| 1548749351 | Jaber's Pharmacy, Inc. | Pharmacy | 2210 Orange Ave, Fort Pierce, FL 34950 | 2018-08-13 |
| 1386139699 | Pas Substance Abuse, Inc. | Substance Abuse Rehabilitation Facility | 2017 Avenue D, Fort Pierce, FL 34950 | 2018-06-28 |
| 1629573134 | Southeastern Dme LLC | Durable Medical Equipment & Medical Supplies | 200 S Indian River Dr Ste 300, Fort Pierce, FL 34950 | 2018-03-27 |
| 1962903666 | Serenity Dme LLC | Durable Medical Equipment & Medical Supplies | 111 N 2nd St Ste 101, Fort Pierce, FL 34950 | 2018-02-27 |
| 1417463068 | Ryan Nippes | Counselor | 1302 N Lawnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1639685282 | Valencia Worrell | Counselor | 1302 N Lswnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1194173153 | Angel French | Massage Therapist | 101 North Us1, Suite 117, Fort Pierce, FL 34950 | 2016-06-01 |
| 1780052951 | Alison Hess | Physician Assistant | 1700 S. 23rd St, Fort Pierce, FL 34950 | 2015-09-04 |
| 1629329784 | Dr. Rhaina A Smeds, Psyd Inc. | Psychologist | 100 Ave A, Ste 2d, Ft. Pierce, FL 34950 | 2012-09-28 |
| Find all providers in zip 34950 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720376940 | Jessica Marie Hamilton Tedder | Nurse Practitioner | 2100 Nebraska Ave, Suite 113, Fort Pierce, FL 34950-4704 | 2011-07-21 |
| 1457377921 | Marisa L. Bracero | Nurse Practitioner | 1505 Delaware Ave, Fort Pierce, FL 34950-3975 | 2006-07-15 |
| 1215906557 | Rosario Correa | Nurse Practitioner | 1505 Delaware Ave, Fort Pierce, FL 34950-3975 | 2006-03-17 |
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|---|---|---|---|---|
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| 1366043614 | Christi Koshy | Nurse Practitioner | 4025 N Nob Hill Rd Apt 207, Sunrise, FL 33351-5811 | 2020-11-03 |
| 1730789322 | Michelle Yen-vera | Nurse Practitioner | 18409 Nw 9th Ct, Pembroke Pines, FL 33029-3607 | 2020-11-01 |
| 1376143487 | Aimee N Jorgenson Stough | Nurse Practitioner | 91550 Overseas Hwy Ste 209, Tavernier, FL 33070-2513 | 2020-10-28 |
| 1588271233 | Olivia Janelle De Jong | Nurse Practitioner | 424 Ne 6th St Apt D, Gainesville, FL 32601-5576 | 2020-09-28 |
| 1801407796 | Elisabeth Morley Chinlund | Nurse Practitioner | 445 Delmar Ter S Apt 5, Saint Petersburg, FL 33701-4653 | 2020-08-13 |
| 1972113025 | Nicole Horn | Nurse Practitioner | 8095 Spyglass Hill Rd Ste 104, Melbourne, FL 32940-8290 | 2020-08-04 |
| 1073131850 | Olivia Dawn Wilson | Nurse Practitioner | 5105 Clover Mist Dr, Apollo Beach, FL 33572-3417 | 2020-07-08 |
| 1427687565 | Cortney M Starr | Nurse Practitioner | 2261 Kingfisher Ln, Clearwater, FL 33762-3323 | 2020-04-01 |
| 1285263335 | Summer Leigh Moran | Nurse Practitioner | 528 W Baldwin Rd # A, Panama City, FL 32405-3313 | 2020-04-01 |
| Find all providers with the same taxonomy | ||||
| City | FORT PIERCE |
| Zip Code | 34950 |
Please comment or provide details below to improve the information on KACY BLADERGROEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.