NICOLE BLOHM (NPI# 1700018728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700018728 |
| Entity Type | Individual |
| Full Name | NICOLE BLOHM |
| Practice Address |
5727 Prosperity Crossing Dr Suite 2200 Charlotte NC 28269-2206 |
| Practice Telephone | 7048639830 |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2019-02-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0010-01566 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5727 PROSPERITY CROSSING DR SUITE 2200 |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28269-2206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548254956 | Heather Knutson | Pediatrics | 5727 Prosperity Crossing Dr, Ste 1500, Charlotte, NC 28269-2206 | 2005-08-31 |
| 1922549385 | Catherine Mcclellan | Physician Assistant | 5727 Prosperity Crossing Dr, Ste 2200, Charlotte, NC 28269-2206 | 2017-03-17 |
| 1457747842 | Neema Hooker | Family Medicine | 5727 Prosperity Crossing Dr, Ste 2200, Charlotte, NC 28269-2206 | 2015-04-13 |
| 1275929648 | Ashley Ham | Pediatrics | 5727 Prosperity Crossing Dr, Ste 1500, Charlotte, NC 28269-2206 | 2015-04-12 |
| 1982015335 | Karen Leeds | Pediatrics | 5727 Prosperity Crossing Dr, Ste 1500, Charlotte, NC 28269-2206 | 2014-05-19 |
| 1982049326 | Husna Khan | Pediatrics | 5727 Prosperity Crossing Dr, Ste 1500, Charlotte, NC 28269-2206 | 2013-04-29 |
| 1366780413 | Vicki Shipman | Nurse Practitioner | 5727 Prosperity Crossing Dr, Ste 1100, Charlotte, NC 28269-2206 | 2013-01-24 |
| 1710278361 | Cecilie Only | Family Medicine | 5727 Prosperity Crossing Dr, Ste 2200, Charlotte, NC 28269-2206 | 2011-04-29 |
| 1710289848 | Elizabeth Schaefer | Physician Assistant | 5727 Prosperity Crossing Dr, Ste 2200, Charlotte, NC 28269-2206 | 2010-11-22 |
| 1790003580 | Eastover University Obstetrics & Gynecology Associates | Obstetrics & Gynecology | 5727 Prosperity Crossing Dr, Ste 2100, Charlotte, NC 28269-2206 | 2010-05-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124664438 | Alluring Occupational Therapy Services, Pllc | Occupational Therapy Assistant | 3020-i Prosperity Church Rd, Ste 523, Charlotte, NC 28269 | 2019-11-21 |
| 1366085094 | Crystal R Currie | Counselor | 8824 Cliff Cameron Drive, Uint 107, Charlotte, NC 28269 | 2019-10-25 |
| 1477102879 | Apryl N. Davis | Occupational Therapy Assistant | 3020-i Prosperity Church Rd., Charlotte, NC 28269 | 2019-09-09 |
| 1730744202 | Christopher Paige | Driver | 9805 Statesville Rd., Suite 6198, Charlotte, NC 28269 | 2019-05-09 |
| 1619532892 | Krb Support Services | Prevention Professional | 11634 Oak Street, Charlotte, NC 28269 | 2019-05-03 |
| 1184186769 | Kimberly M Lynch | Local Education Agency (LEA) | 11634 Oat Street, Charlotte, NC 28269 | 2019-04-03 |
| 1356802318 | Arleen M Blythe | Physical Therapy Assistant | 1521 Bucklebury Ct, Charlotte, NC 28269 | 2019-03-30 |
| 1174089064 | Quality Behavioral Health Services, Pllc | Social Worker | 9805 Statesville Rd, # 6095, Charlotte, NC 28269 | 2019-02-15 |
| 1326517855 | Mary Frances Pickens-wilson | Behavior Technician | 4628 Quinton Lane, Charlotte, NC 28269 | 2018-11-14 |
| 1548746605 | Tiffany Michelle Graham | Counselor | 9823 Cooper Run Ln, Charlotte, NC 28269 | 2018-07-12 |
| Find all providers in zip 28269 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396351607 | Michael James Blackwell | Physician Assistant | 501 Billingsley Rd Ste B, Charlotte, NC 28211-1009 | 2020-09-22 |
| 1598371320 | Jonathan Byron Lively | Physician Assistant | 1000 Blythe Blvd Fl 3, Charlotte, NC 28203-5812 | 2020-09-17 |
| 1902415532 | Jacqueline Ellen Leyrer | Physician Assistant | 2630 E 7th St Ste 200, Charlotte, NC 28204-4319 | 2020-07-29 |
| 1750908380 | Whitney Debroy | Physician Assistant | 125 W Tremont Ave Unit 726, Charlotte, NC 28203-5551 | 2020-06-30 |
| 1972129302 | Ashley Nicole Short | Physician Assistant | 1022 E Worthington Ave, Charlotte, NC 28203-5760 | 2020-06-22 |
| 1558985176 | Courtney Claugus | Physician Assistant | 300 E Park Ave Unit 7, Charlotte, NC 28203-4774 | 2020-05-29 |
| 1467071738 | Patrick James Quinn | Physician Assistant | 2036 Millerton Ave Apt 4311, Charlotte, NC 28208-5290 | 2020-04-15 |
| 1225660301 | Sunil Ranchhod Ghodasara | Physician Assistant | 1001 Blythe Blvd Ste 403, Charlotte, NC 28203-5863 | 2020-02-06 |
| 1225668601 | Emily Rebecca Markey | Physician Assistant | 355 W Mlk Blvd Apt 1112, Charlotte, NC 28202-0043 | 2020-01-24 |
| 1639719586 | Abosede Elizabeth Adamson | Physician Assistant | 3101 Amesbury Hill Dr, Charlotte, NC 28269-8951 | 2020-01-08 |
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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.