BLAIR SHEALY


Address: 4077 5th Ave, San Diego, CA 92103-2105
Phone: 6192948111

BLAIR SHEALY (NPI# 1972070662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972070662
Entity Type Individual
Full Name BLAIR SHEALY
Practice Address 4077 5th Ave
San Diego
CA 92103-2105
Mailing Address 10140 Campus Point Dr
San Diego
CA 92121-1520
Practice Telephone 6192948111
Mailing Telephone 6192948111
Enumeration Date 2018-10-31
Last Update Date 2020-04-13
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207R00000X Internal Medicine 95010273 CA Allopathic & Osteopathic Physicians
Y 363L00000X Nurse Practitioner NPF95010273 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4077 5TH AVE
City SAN DIEGO
State CA
Zip Code 92103-2105

Providers in the same location

NPI Name Taxonomy Address Enumeration
1932100062 Julian George Lis Emergency Medicine 4077 5th Ave, San Diego, CA 92103-2105 2005-08-10
1154921195 Michelle Miller Social Worker 4077 5th Ave, San Diego, CA 92103-2105 2020-10-29
1356972798 Andrew Nasseri Md Inc. Surgery 4077 5th Ave, San Diego, CA 92103-2105 2020-02-03
1134769573 Emi Harris Nurse Practitioner 4077 5th Ave, San Diego, CA 92103-2105 2020-01-14
1669012217 Justin Jerluen Lin Pharmacist 4077 5th Ave, Mer 52, San Diego, CA 92103 2020-01-12
1487143749 Jovian W Lam Internal Medicine 4077 5th Ave, San Diego, CA 92103 2018-05-02
1316452303 Meghan Murphy Social Worker 4077 5th Ave, San Diego, CA 92103-2105 2017-12-12
1508390394 Kristina Strong Nurse Practitioner 4077 5th Ave, San Diego, CA 92103-2105 2017-04-18
1124578117 Jennifer Agueda Nurse Practitioner 4077 5th Ave, San Diego, CA 92103-2105 2016-10-13
1013309962 Brody Tucker Social Worker 4077 5th Ave, San Diego, CA 92103-2105 2015-03-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174140057 Carmel Agdeppa Acupuncturist Chiropractique, 813 West Washington St., San Diego, CA 92103 2020-06-26
1568082717 Salina Ann Bambic Social Worker 302 Washington Street Suite 420, San Diego, CA 92103 2020-04-17
1467099432 Lina Hong Behavior Technician 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 2019-12-09
1154964567 Rodger Stacy Questin, Psychologist P.C. Psychologist 440 Upas St Apt 402, San Diego, CA 92103 2019-10-18
1932740388 Grace Tong-ventura Pharmacist 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 2019-10-07
1306490453 Genevieve Cheung Pharmacist 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 2019-07-26
1801356837 Marika Doviak Acupuncturist 2370 Hickory St, San Diego, CA 92103 2019-03-25
1982185070 Tyler Lewis Roberts Counselor 4303 3rd Ave, San Diego, CA 92103 2018-08-27
1689151284 Tori Breanne Blackwell Occupational Therapist 3731-a 6th Avenue, San Diego, CA 92103 2018-07-26
1952892614 Pacific Bay Recovery Inc Substance Abuse Rehabilitation Facility 4095 Jackdaw St, San Diego, CA 92103 2018-05-29
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417560467 Helen Regina Stearns Nurse Practitioner 8797 Encino Ave, San Diego, CA 92123-3952 2020-08-28
1346852480 Jenna Juenger Nurse Practitioner 10665 Calle Mar De Mariposa Apt 3215, San Diego, CA 92130-8730 2020-08-19
1750908414 Deborah Lynne Monaghan Nurse Practitioner 14471 Via Venezia Apt 601, San Diego, CA 92129-1657 2020-06-29
1780211300 Amanda Renee Phillips Nurse Practitioner 3034 Horton Ave, San Diego, CA 92103-6008 2020-03-24
1538792304 Allison D White Nurse Practitioner 726 W Pennsylvania Ave, San Diego, CA 92103-3804 2020-02-19
1356981351 Jordan Rae Burke Nurse Practitioner 11943 El Camino Real Ste 100, San Diego, CA 92130-2597 2020-01-08
1598319436 Madison Taylor Shreeve Nurse Practitioner 3435 Del Mar Heights Rd # D6a, San Diego, CA 92130-2225 2019-07-29
1659930485 Lovella Medilo Nurse Practitioner 4033 3rd Ave Ste 430, San Diego, CA 92103-2117 2019-06-05
1306300272 Stephanie O'brien Sramek Nurse Practitioner 4077 5th Ave # Ems, San Diego, CA 92103-2105 2019-01-25
1467930875 Reliable Care Md On The Go Nurse Practitioner 4565 Ruffner St Ste 201, San Diego, CA 92111-2259 2018-07-30
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Competitor

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City SAN DIEGO
Zip Code 92103

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Dataset Information

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.

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