AMY ELIZABETH BLANCKE (NPI# 1538729421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538729421 |
| Entity Type | Individual |
| Full Name | AMY ELIZABETH BLANCKE |
| Credential | AGACNP |
| Practice Address |
1121 5th Ave Ste 100 Fort Worth TX 76104-4386 |
| Mailing Address |
P.o. Box 961205 Fort Worth TX 76161-1205 |
| Practice Telephone | 8174238585 |
| Practice Fax Number | 8174238458 |
| Mailing Telephone | 8177408400 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-07-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | AP142394 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1121 5TH AVE STE 100 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76104-4386 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134233588 | Mohanakrishnan Sathyamoorthy | Internal Medicine | 1121 5th Ave Ste 100, Fort Worth, TX 76104-4386 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669082186 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 1115 8th St, Fort Worth, TX 76104 | 2020-08-10 |
| 1992343693 | Iris Giove | Psychologist | John Peter Smith Hospital, 1500 S. Main St., Fort Worth, TX 76104 | 2019-12-13 |
| 1104480656 | Swarnalaxmi Umapathy | Student in an Organized Health Care Education/Training Program | 900 8th Avenue, Fort Worth, TX 76104 | 2019-04-30 |
| 1881189132 | Mega Surgical Assistants LLC | Specialist/Technologist, Other | 1301pennsylvania, Fort Worth, TX 76104 | 2018-06-28 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1952820979 | Modern Vein Clinic | Internal Medicine | 757 8th Avenue, Suite A, Forth Worth, TX 76104 | 2017-09-11 |
| 1790207165 | Vanessa Abbood | Dietitian, Registered | 900 Eighth Ave, Fns Department, Fort Worth, TX 76104 | 2017-07-07 |
| 1922537562 | Nicole Marie Tod | Student in an Organized Health Care Education/Training Program | 1500 S Main Street, Fort Worth, TX 76104 | 2017-06-07 |
| 1770025934 | Micah Bonola | Chiropractor | 1300 W. Rosedale St, Ste. A, Fort Worth, TX 76104 | 2016-11-04 |
| 1518315894 | United Bioscience, LLC. | Clinical Medical Laboratory | 901 W. Leuda St., B, Fort Worth, TX 76104 | 2016-05-27 |
| Find all providers in zip 76104 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356940837 | Katherine Anna Nack | Nurse Practitioner | 6100 Harris Pkwy Ste 285, Fort Worth, TX 76132-4127 | 2020-10-26 |
| 1588299077 | Godling Obi Onyegbunwa | Nurse Practitioner | 4200 South Fwy Ste 106, Fort Worth, TX 76115-1407 | 2020-03-05 |
| 1700423233 | Complex Healthcare Solutions, LLC | Nurse Practitioner | 6040 Camp Bowie Blvd Ste 24, Fort Worth, TX 76116-5602 | 2019-12-03 |
| 1689149858 | Teresa Leverenz | Nurse Practitioner | 5751 Edwards Ranch Rd, Fort Worth, TX 76109-4120 | 2018-10-03 |
| 1972094779 | Damita Jo Jones | Nurse Practitioner | 8450 East Fwy, Fort Worth, TX 76120-4413 | 2018-05-29 |
| 1548750136 | Bianca Maria Armstrong | Nurse Practitioner | 4364 Heritage Trace Pkwy Ste 104, Fort Worth, TX 76244-9125 | 2018-05-18 |
| 1356848899 | Tricia Kelly | Nurse Practitioner | 1325 Pennsylvania Avenue Suite 560, Fort Worth, TX 76104 | 2018-04-11 |
| 1225542855 | Alicia Marie Segovia | Nurse Practitioner | 6100 Harris Pkwy Ste 340, Fort Worth, TX 76132-4133 | 2017-11-17 |
| 1083137202 | Jordan Deneen Costlow | Nurse Practitioner | 1250 8th Ave Ste 435, Fort Worth, TX 76104-4144 | 2017-07-19 |
| 1558884809 | Tambra B Guinn | Nurse Practitioner | 2300 Circle Dr Ste 2307, Fort Worth, TX 76119-8134 | 2017-07-19 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76104 |
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| 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.