Ms Kimberly Lorene Blake, FNP-C in Conway, AR

Ms Kimberly Lorene Blake, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Conway, Arkansas. She graduated from nursing school in 2010 and has 14 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Faulkner Emergency Group, Pllc and her current practice location is 1125 Skyline Dr, Conway, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 358-6120.

Ms Kimberly Lorene Blake is licensed to practice in Arkansas (license number A03482 ANP) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1689971749.

Contact Information

	Ms Kimberly Lorene Blake, FNP-C
	1125 Skyline Dr, Conway, AR 72032-6657
	(501) 358-6120
	(501) 358-6268

Map and Direction

Provider's Profile

Full Name	Ms Kimberly Lorene Blake
Gender	Female
Speciality	Nurse Practitioner
Experience	14 Years
Location	1125 Skyline Dr, Conway, Arkansas
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ms Kimberly Lorene Blake graduated from nursing school in 2010

NPI Data:

NPI Number: 1689971749
Provider Enumeration Date: 02/24/2011
Last Update Date: 05/10/2017

Medicare PECOS Information:

PECOS PAC ID: 0941474738
Enrollment ID: I20111111000667

Medical Identifiers

Medical identifiers for Ms Kimberly Lorene Blake such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689971749	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	A03482 ANP (Arkansas)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Conway Regional Health System	Conway, AR	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Faulkner Emergency Group, Pllc	1557694049	18

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. Ms Kimberly Lorene Blake allows following entities to bill medicare on her behalf.

Entity Name	Conway Regional Medical Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417024662 PECOS PAC ID: 3173428414 Enrollment ID: O20050825001031

Entity Name	Ozark Medical Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366614935 PECOS PAC ID: 2769559848 Enrollment ID: O20080916000561

Entity Name	Faulkner Emergency Group, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083279533 PECOS PAC ID: 1557694049 Enrollment ID: O20190617000848

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. Ms Kimberly Lorene 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
Ms Kimberly Lorene Blake, FNP-C 1125 Skyline Dr, Conway, AR 72032-2857 Ph: (501) 358-6120	Ms Kimberly Lorene Blake, FNP-C 1125 Skyline Dr, Conway, AR 72032-6657 Ph: (501) 358-6120

Reviews and Comments

Nurse Practitioner Nurses in Conway, AR

Marina Gray, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 495 Hogan Ln Ste 2, Conway, AR 72034 Phone: 501-358-6695 Fax: 501-358-6860
Mckenzie Lauren Cotton, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1065 Skyline Dr, Conway, AR 72032 Phone: 501-499-6222
Cynthia Lou Grubbs, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 495 Hogan Ln, Conway, AR 72034 Phone: 501-327-1150 Fax: 501-327-3427
Mrs. Leah Maranda Martin, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1014 Harkrider St, Suite B, Conway, AR 72032 Phone: 501-327-7100 Fax: 501-279-9011
Keisha A. Fox, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 Salem Rd Ste 1, Conway, AR 72034 Phone: 479-518-4977 Fax: 479-203-3030
Mrs. Shakenia A Tate, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 150 E Siebenmorgen Rd, Conway, AR 72032 Phone: 501-329-6851
David Adam Steinfeld, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 855 S German Ln Ste 1, Conway, AR 72034 Phone: 501-358-6606 Fax: 501-325-5554

Ms Kimberly Lorene Blake, FNP-C - Medicare Nurse Practitioner in Conway, AR