Individual Healthcare Provider
Jo Blasengame, AGACNP-BC
Provider's NPPES record last updated: January 27, 2023
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1356005250
- Primary Specialty
- Nurse Practitioner
- Practice Location
- Pine Bluff, Arkansas
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 20, 2026, 7:46 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Nurse Practitioner
Physician Assistants & Advanced Practice Nursing Providers
(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.
Taxonomy code 363L00000X Nurse Practitioner
Acute Care
Physician Assistants & Advanced Practice Nursing Providers
Definition to come...
Taxonomy code 363LA2100X
Provider-Reported License Information
- Nurse Practitioner (Arkansas)
- 217776
- Nurse Practitioner (Arkansas)
- 217776
Practice Locations
Practice Location
1609 W 40th Ave Ste 205
Pine Bluff, Arkansas 71603-6367
Phone: (870) 541-7211
Additional Practice Location
2894 Autumn Hills Rd
Star City, Arkansas 71667-9554
Phone: (870) 628-3842
Additional Practice Location
4310 S Mulberry St
Pine Bluff, Arkansas 71603-7030
Phone: (870) 541-7211
Additional Practice Location
1609 W 40th Ave Ste 111
Pine Bluff, Arkansas 71603-6319
Phone: (870) 541-7211
Record Information
- Enumeration Date
- October 26, 2021
- Provider's NPPES Record Last Updated
- January 27, 2023
- Certification Date
- January 27, 2023
- NPISignal NPPES Dataset
- August 2026
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