DR. JEFFREY A BLALACK (NPI# 1033175161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033175161 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY A BLALACK |
| Credential | MD |
| Practice Address |
1265 Union Ave Memphis TN 38104-3415 |
| Mailing Address |
6060 Primacy Pkwy Suite 241 Memphis TN 38119-5745 |
| Practice Telephone | 3166856091 |
| Mailing Telephone | 9017255846 |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 24263 | MS | Allopathic & Osteopathic Physicians |
| Y | 207L00000X | Anesthesiology | 25520 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3084438 | 05 |
| Street Address |
1265 UNION AVE |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304107 | David P Fang | Radiology | 1265 Union Ave, Memphis, TN 38104-3415 | 2005-05-23 |
| 1467069369 | Melissa Madolyn Morgan | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-09-25 |
| 1306459516 | Vladyslava Inman | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-26 |
| 1073126553 | Katherine Ann Palo | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-25 |
| 1194335729 | Britney Michelle Holton | Nurse Practitioner | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-08-07 |
| 1568082394 | Joan Danelle Morris | Dietitian, Registered | 1265 Union Ave, 4th Floor, Shorb Tower, Memphis, TN 38104 | 2020-04-22 |
| 1255950648 | Liza Southerton | Dietitian, Registered | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-04-15 |
| 1306465711 | Andrew Tutor | Student in an Organized Health Care Education/Training Program | 1265 Union Ave, Thomas Wing, 7th Floor, Rm 707, Memphis, TN 38104 | 2020-04-15 |
| 1275152761 | Jessica Galtelli | Dietitian, Registered | 1265 Union Ave, 612 Thomas, Nutrition Dept, Memphis, TN 38104 | 2020-04-14 |
| 1932728029 | Allison Elizabeth Bray | Dietitian, Registered | 1265 Union Ave, Memphis, TN 38104-3415 | 2020-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952900367 | Christy White | Recreation Therapist | 1030 Jefferson Ave (rt117), Memphis, TN 38104 | 2020-10-19 |
| 1821615873 | Altiana Carter | Optometrist | 650 New York St, Memphis, Tn 38104, Memphis, TN 38104 | 2020-06-25 |
| 1952898413 | Family To Family Adult Care Service | Chore Provider | 1331 Union Ave Suite 1028, Mempnis, TN 38104 | 2018-04-19 |
| 1326544800 | Kimberly Vestoria Mcclinton | Nurse Practitioner | 2200 Union Ave 1, Memphis, TN 38104 | 2018-04-03 |
| 1649799339 | Benjamin Duhart Jr. | Pharmacist | 1265 Union Avenue- Methodist University Hospital, Ground Floor Pharmacy Administration, Memphis, TN 38104 | 2017-09-13 |
| 1134644982 | Amy Michelle Wise | Nurse Practitioner | 1325 Eastmoreland Ave Ste 500, Memphis, TN 38104 | 2017-08-13 |
| 1316468572 | Jinger Cathey | Social Worker | 1330 Jefferson Ave, Memphis, TN 38104 | 2017-06-28 |
| 1336669183 | Charma May Kavuncu | Social Worker | 1407 Union Ave Ste 1100, Memphis, TN 38104 | 2017-06-22 |
| 1003345398 | Angelica J Dennis | Nurse Practitioner | 1265 Union, Memphis, TN 38104 | 2017-06-08 |
| 1609302546 | Cheryl Beene | Nurse Practitioner | 1211 Union Ave Ste 475, Memphis, TN 38104 | 2017-05-11 |
| Find all providers in zip 38104 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598058075 | Jennifer Nguyen | Anesthesiology | 1068 Cresthaven, Suite 150, Memphis, TN 38119 | 2011-05-17 |
| 1205151776 | Kyle Joseph Morgan | Anesthesiology | 262 Danny Thomas Pl Dept Of, Memphis, TN 38105 | 2010-03-28 |
| 1184950115 | Patsy-ruth Erwin Kiefer | Anesthesiology | 4500 Chickasaw Rd., Memphis, TN 38117 | 2009-10-27 |
| 1639332349 | Jerry L Scruggs | Anesthesiology | 5954 Brierhedge Ave, Memphis, TN 38120-2328 | 2008-07-03 |
| 1598923039 | Vipul Hasmukh Saparia | Anesthesiology | 1068 Cresthaven Rd Ste 150, Memphis, TN 38119-3859 | 2008-05-31 |
| 1295876621 | Adam Willis | Anesthesiology | 50 North Dunlap, Memphis, TN 38103-5099 | 2007-02-09 |
| 1710038161 | Jack Andrew Goodman | Anesthesiology | 4515 Poplar Ave Ste 426, Memphis, TN 38117-7517 | 2007-01-14 |
| 1104993773 | Kit Sanford Mays | Anesthesiology | 55 Humphreys Center Drive Suite 200, Pain Clinic Associates PC, Memphis, TN 38120-2366 | 2006-11-29 |
| 1588734727 | Edward Richard Moran Jr. | Anesthesiology | 5959 Park Avenue, St Francis Hospital, Memphis, TN 38119-5198 | 2006-11-08 |
| 1255386777 | Pinnacle Health, LLC | Anesthesiology | 5100 Poplar Ave Ste 2700, Memphis, TN 38137-2700 | 2006-05-23 |
| Find all providers in MEMPHIS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.