ANDREW LEE BLALOCK (NPI# 1447557657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447557657 |
| Entity Type | Individual |
| Full Name | ANDREW LEE BLALOCK |
| Credential | IDC |
| Practice Address |
97 W Main St Apt 47 Niantic CT 06357-1749 |
| Mailing Address |
97 West Main St Apt 47 Niantic CT 06357-1731 |
| Practice Telephone | 3054925489 |
| Mailing Telephone | 3054925489 |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2011-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659415412 | Andrew Clark Blalock | Psychologist | 4167 Roswell Rd Ne, Atlanta, GA 30342-3715 | 2007-02-16 |
| Street Address |
97 W MAIN ST APT 47 |
| City | NIANTIC |
| State | CT |
| Zip Code | 06357-1749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093094401 | Pamela Dhillon | Nurse Practitioner | 215 West Main St, Niantic, CT 06357 | 2011-08-16 |
| 1841454485 | Richard Frederick Jones IIi | Obstetrics & Gynecology | 224 Old Balck Point Rd, Niantic, CT 06357 | 2008-07-14 |
| 1437224771 | Margaret C Barili | Registered Nurse | 369 Main Street, Niantic, CT 06357 | 2006-11-21 |
| 1720163942 | Carole C Olson | Psychologist | 4 N. Pine Street, Ninantic, CT 06357 | 2006-10-26 |
| 1427151513 | Melvin Harold Engel | Family Medicine | 50 Green Cliff Drive, Niantic, CT 06357 | 2006-09-06 |
| 1457304420 | Michele Nadine Litwin | Nurse Practitioner | 30 W Main Street, Niantic, CT 06357 | 2006-05-18 |
| 1487133906 | Ryne Mcmullen | Physical Therapist | 11 Freedom Way Unit B2, Niantic, CT 06357 | 2018-08-07 |
| 1558720854 | Bodhi Naturopathic LLC | Naturopath | 17 Hope Street, Nianic, CT 06357 | 2016-02-15 |
| 1477980480 | Heather Michelle Rynkowski | Physician Assistant | 365 Montauk Ave, Office # 3.525, New London, CT 06357 | 2013-10-04 |
| 1245662592 | Erica L Lussier | Nurse Practitioner | 248 Flanders Rd, Niantic, CT 06357 | 2013-08-08 |
| Find all providers in zip 06357 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052819 | Kenny Daniel Harp | Military Health Care Provider | 59 Deerwood Dr, Groton, CT 06340-2513 | 2020-01-09 |
| 1982244737 | Lonnie Jay Reardon | Military Health Care Provider | 55 South Rd Apt 12c, Groton, CT 06340-4660 | 2020-01-09 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1679132112 | Hector Salvador Gonzalez | Military Health Care Provider | 2 Bushnell St, Groton, CT 06340-3306 | 2019-06-09 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1558929026 | Joshua Darren Savage | Military Health Care Provider | 35 Chrissos St, Groton, CT 06340-3307 | 2019-05-30 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1992241228 | Phillip Lawernce Hardy Sr. | Military Health Care Provider | 123 Trout Ave, Naval Undersea Medical Institiute, Groton, CT 06340-5159 | 2017-01-10 |
| Find all providers with the same taxonomy | ||||
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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.