DR. RUSSELL R BLAKELEY (NPI# 1063409639) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063409639 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL R BLAKELEY |
| Credential | M.D. |
| Practice Address |
606 N Third Ave Suite 203 Sandpoint ID 83864-1594 |
| Mailing Address |
2003 Kootenai Health Way Coeur D Alene ID 83814-6051 |
| Practice Telephone | 2082638505 |
| Practice Fax Number | 2082632908 |
| Mailing Telephone | 2086525250 |
| Mailing Fax Number | 2086255251 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2016-01-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
16299 | TN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | 3859386 | 05 |
| Street Address |
606 N THIRD AVE SUITE 203 |
| City | SANDPOINT |
| State | ID |
| Zip Code | 83864-1594 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952308405 | Scott Ronald Dunn | Family Medicine | 606 N Third Ave, Suite #101, Sandpoint, ID 83864-1594 | 2005-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842600 | Deblaquiere Enterprises, Inc. | Pharmacy | 1319 Hwy 2, Suite A, Sandpoint, ID 83864 | 2020-05-07 |
| 1245867670 | Kimberly Sue Batchelder | Massage Therapist | Sandpoint Medical Massage & Bodyworks, LLC, 515 Pine Street Ste G., Sandpoint, ID 83864 | 2020-03-25 |
| 1699309963 | Ckam Rejuvenation Center LLC | Massage Therapist | 1315 Us-2, #5, Sandpoint, ID 83864 | 2020-02-26 |
| 1427602986 | Alpine Hand Therapy Inc | Physical Medicine & Rehabilitation | 1205 Hwy 2, Suite 102, Sandpoint, ID 83864 | 2019-08-01 |
| 1295388536 | Momentum Medical Massage and Personal Training, LLC | Massage Therapist | 1013 W Lake St, Sandpoint, ID 83864 | 2019-07-16 |
| 1629508932 | Karen Elizabeth Vollmer-poseley | Counselor | 506 N. 4th Ave, Sandpoint, ID 83864 | 2017-06-19 |
| 1760912042 | Gregory Jon Anthony Prins | Dentist | 1305 Highway 2 West, Sandpoint, ID 83864 | 2017-06-19 |
| 1730547084 | Charity Catlin | Midwife | 204 N 4th Ave #2355, Sandpoint, ID 83864 | 2016-02-02 |
| 1497148860 | Loftus Family Dental - Sandpoint Pllc | Dentist | 1310 Ponderosa Drive, Suite A, Sandpoint, ID 83864 | 2015-03-10 |
| 1215365523 | Tamarack Treatment and Counseling Center, Pllc | Counselor | 101 N. Boyer Ave, Sandpoint, ID 83864 | 2013-10-23 |
| Find all providers in zip 83864 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700889607 | Gregory D Pennock | Internal Medicine | 423 N Third Ave Ste 335, Sandpoint, ID 83864 | 2005-05-24 |
| 1366756868 | Providence Health & Services | Internal Medicine | 606 N 3rd Ave, 606 N 3, Sandpoint, ID 83864-1691 | 2010-07-27 |
| 1184938680 | Providence Health & Services | Internal Medicine | 207 Church St, Sandpoint, ID 83864-1342 | 2010-07-27 |
| 1770896607 | Providence Health & Services - Washington | Internal Medicine | 606 N 3rd Ave, Suite 203, Sandpoint, ID 83864-1691 | 2010-07-20 |
| 1992751648 | Ronald D Jenkins | Internal Medicine | 606 N 3rd Ave, Suite 203, Sandpoint, ID 83864-1570 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1801336276 | Bmh, Inc. | Internal Medicine | 235 Poplar St, Blackfoot, ID 83221 | 2017-03-03 |
| 1811201312 | Providence Health & Services | Internal Medicine | 715 S Washington, Suite A, Moscow, ID 83843-0000 | 2010-07-27 |
| 1730323080 | Wayne Wright | Internal Medicine | 2664 E 3700 N, Twin Falls, ID 83301-0145 | 2009-04-29 |
| 1184824617 | Michael D Kenner, Md,pc | Internal Medicine | 1721 S 10th Ave, Caldwell, ID 83605-4839 | 2007-07-23 |
| 1497807812 | Grande Ronde Hospital, Inc | Internal Medicine | 300 E Jefferson St Ste 101, Boise, ID 83712-6221 | 2007-01-17 |
| 1700983137 | Lee Walter Gould | Internal Medicine | 307 St. John's Way, Suite 114, Lewiston, ID 83501-2456 | 2006-09-20 |
| 1730285719 | Beth R Malasky | Internal Medicine | 6140 Curtisian, Ste 200, Boise, ID 83704-0107 | 2006-09-16 |
| 1730192329 | Cardiovascular Consultants of Idaho | Internal Medicine | 1070 N Curtis Rd, Ste 125, Boise, ID 83706-1238 | 2006-08-14 |
| 1477578300 | John E Lassetter | Internal Medicine | 2001 S Woodruff Ave Ste 3, Idaho Falls, ID 83404 | 2006-07-13 |
| Find all providers with the same taxonomy | ||||
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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.