TRACI LEIGH BLAKE DNP,ACNPC-AG, CRNFA
NPI 1649543042
Nurse Practitioner - Acute Care in Rockford, IL
About Traci Leigh Blake Dnp,acnpc-ag, Crnfa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TRACI LEIGH BLAKE DNP,ACNPC-AG, CRNFA (NPI 1649543042) is an individual acute care provider in Rockford, Illinois, licensed in Illinois (209032163) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS, is affiliated with Javon Bea Hospital, and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 2
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
Traci Leigh Blake Dnp,acnpc-ag, Crnfa 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Javon Bea Hospital
Acute Care Hospitals · Rockford, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 61114 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ROCKFORD, IL 61114
ROCKFORD, IL 61114
ROCKFORD, IL 61114
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Traci Blake's NPI number?
The NPI number for Traci Blake is 1649543042. It was assigned to this individual provider in the NPPES registry on February 15, 2012. The provider is also known as Traci L Goodell.
Where is Traci Blake located?
Traci Blake practices at 8201 E Riverside Blvd, Rockford, IL 61114. The listed phone number is (815) 971-7000.
What is Traci Blake's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Traci Blake enrolled in Medicare?
Yes. Traci Blake is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Is Traci Blake affiliated with any hospitals?
According to CMS data, Traci Blake is affiliated with Javon Bea Hospital.
When was this NPI record last updated?
The NPPES record for Traci Blake was last updated on May 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.
# Traci Leigh Blake, DNP,ACNPC-AG, CRNFA · NPI 1649543042
Acute Care physician in Rockford, Illinois. Individual provider, active in the CMS NPPES registry since February 15, 2012.
## Identity
- **NPI:** 1649543042 (Entity type: Individual)
- **Enumerated:** February 15, 2012
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 209032163 (Illinois)
- **Sole proprietor:** No
## Practice location
- **Address:** 8201 E RIVERSIDE BLVD, Rockford, IL 61114-2300
- **Phone:** (815) 971-7000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** May 1, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1649543042) · Data from the CMS NPPES public registry.