JODEE L BLAZE (NPI# 1093955593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093955593 |
| Entity Type | Individual |
| Full Name | JODEE L BLAZE |
| Credential | CRNA |
| Practice Address |
737 Broadway N Fargo ND 58102-4421 |
| Practice Telephone | 7012346258 |
| Mailing Telephone | 7012346258 |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2010-02-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | R34791 | ND | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | R 152598-2 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1093955593 | 05 | |
| MN | MEDICARE RAILROAD | P00733656 | 01 |
| Street Address |
737 BROADWAY N |
| City | FARGO |
| State | ND |
| Zip Code | 58102-4421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023040219 | Jerome I Thompson | Surgery | 737 Broadway N, Fargo, ND 58122-0001 | 2006-07-07 |
| 1376160184 | Michael Andrew Kerr | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2020-06-26 |
| 1124645064 | Shelby Rae Bucholz | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2020-06-26 |
| 1700431756 | Joshua Jacob Fisher | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-08-06 |
| 1689229122 | Michael Seaman | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-08-01 |
| 1467004838 | Fiona Lillian Axelsson | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-07-15 |
| 1477115145 | Anuj Mogla | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-07-02 |
| 1376105304 | Erika Singh | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2019-06-29 |
| 1467947564 | Katrina Lee Foster | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2018-06-30 |
| 1629590104 | Evelyn Fuentes-dondoneau | Family Medicine | 737 Broadway N, Fargo, ND 58102-4421 | 2017-07-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
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| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548659808 | Red River Locums LLP | Nurse Anesthetist, Certified Registered | 1507 University Dr S, Fargo, ND 58103-4169 | 2015-01-09 |
| 1336440924 | Megan Maria Dallman | Nurse Anesthetist, Certified Registered | Sanford Health Anesthesia Department, 737 Broadway, Fargo, ND 58122-0001 | 2010-11-12 |
| 1508895954 | Ronald Beare | Nurse Anesthetist, Certified Registered | 2669 Meadow Creek Circle, Fargo, ND 58104-7112 | 2006-06-30 |
| 1982654646 | Todd Arlen Gross | Nurse Anesthetist, Certified Registered | 2301 25th St S Ste K, Fargo, ND 58103-6104 | 2006-05-11 |
| 1669098976 | Nathaniel James Piersol | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-06-23 |
| 1134743941 | Joshua Levee | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-06-08 |
| 1942824388 | Amanda Paulson | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-06-02 |
| 1689298390 | Emily Marshelle Wolters | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-05-29 |
| 1194350132 | Courtney Nicole Huston | Nurse Anesthetist, Certified Registered | 5225 23rd Ave S, Fargo, ND 58104-7927 | 2020-03-10 |
| 1386276863 | Corey David Bos | Nurse Anesthetist, Certified Registered | 3000 32nd Ave S, Fargo, ND 58103-6132 | 2020-02-12 |
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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.