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JOHN MICHAEL BLANCO MATA NP NPI 1639871247


NPI Information

NPI: 1639871247
Provider Name: JOHN MICHAEL BLANCO MATA, NP
Classification: Nurse Practitioner - 363L00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
3250 GATEWAY BLVD STE 112
PRESCOTT, AZ
ZIP 86303
Phone: (708) 248-0049
Get Directions

John Michael Blanco Mata, NP is a nurse practitioner in Prescott, AZ with 2 years of experience. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. John Michael Blanco Mata, NP NPI is 1639871247. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3250 GATEWAY BLVD STE 112
PRESCOTT, AZ
ZIP 86303-856
Phone: (708) 248-0049

The NPI 1639871247 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2023 and was last updated on 1/31/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LA2100XNurse PractitionerAcute Care267971ARIZONANo
2363LA2200XNurse PractitionerAdult Health267971ARIZONANo
3363LC0200XNurse PractitionerCritical Care Medicine267971ARIZONANo
4363L00000XNurse Practitioner267971ARIZONAYes
5363LG0600XNurse PractitionerGerontology267971ARIZONANo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.