SHIRONDA R BLAKE NP
NPI 1306510805
Nurse Practitioner - Family in Shreveport, LA

Q: What is Shironda Blake's NPI number?

The NPI number for Shironda Blake is 1306510805. It was assigned to this individual provider in the NPPES registry on August 6, 2021.

Q: What is Shironda Blake's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Shironda Blake was last updated on August 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 06, 2021PECOS EnrolledAccepts Medicare Assignment

3217 MABEL ST, SHREVEPORT, LA 71103(318) 631-9121(318) 631-9126 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 11, 2022, Aug 5, 2022, Aug 9, 2021 and 1 more (4 updates tracked since 2021).

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About Shironda R Blake Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHIRONDA R BLAKE NP (NPI 1306510805) is an individual family provider in Shreveport, Louisiana, licensed in Louisiana (221102) and active in the NPI registry since August 2021. She is enrolled in Medicare PECOS, is affiliated with Christus Shreveport-bossier Health System, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1306510805

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameSHIRONDA R BLAKECredential: NP

Location Address3217 MABEL STShreveport, LA 71103-4022

Mailing Address3217 Mabel StShreveport, LA 71103-4022 · (318) 631-9121 · Fax (318) 631-9126

Phone(318) 631-9121

Fax(318) 631-9126

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateAugust 6, 2021

Last NPPES UpdateAugust 11, 20224 updates tracked since enumeration

NPPES CertifiedAugust 11, 2022

✔ NPI 1306510805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in LA · 221102

3217 MABEL ST, Shreveport, LA 71103

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Other Identifiers 2

Medicaid2567250LA

Other221102LA · State License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, CHRISTUS Health Plan, HMO Louisiana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shironda R Blake Np is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6800291337

PECOS Enrollment IDI20210823000982

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Christus Shreveport-Bossier Health System

Acute Care Hospitals · Shreveport, LA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number190041

Location1453 E Bert Kouns Industrial LoopShreveport, LA 71105 · Caddo County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 71103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.60 typical visit price

range $53.43 – $164.73

Typical copayment $20.90 (range $13.35 – $41.18)

Most-billed visit code 99203

Established Patient

$95.09 typical visit price

range $16.64 – $133.62

Typical copayment $23.77 (range $4.16 – $33.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HIRAM VAZQUEZ M.D.

Anesthesiology