Amy Blake, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Colfax, Louisiana. Her current practice location is
340 Webb Smith Dr, Colfax, Louisiana. You can reach out to her office (for appointments etc.) via phone at
(318) 627-5021.
Amy Blake is licensed to practice in Louisiana (license number AP07742) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063838464.
Provider's Profile
Full Name | Amy Blake |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 340 Webb Smith Dr, Colfax, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063838464
- Provider Enumeration Date: 03/10/2014
- Last Update Date: 04/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 2961635644
- Enrollment ID: I20140505000032
Medical Identifiers
Medical identifiers for Amy Blake such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063838464 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | AP07742 (Louisiana) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amy Blake allows following entities to bill medicare on her behalf.
Entity Name | C H Wilkinson Physician Network |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1457382947 PECOS PAC ID: 8921919580 Enrollment ID: O20070911000793 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amy Blake is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amy Blake, FNP-C Po Box 1288, Winnfield, LA 71483-1288 Ph: (318) 627-5021 | Amy Blake, FNP-C 340 Webb Smith Dr, Colfax, LA 71417-1910 Ph: (318) 627-5021 |
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