DR. BRIAN J BLAKE (NPI# 1124278668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124278668 |
| Entity Type | Individual |
| Full Name | DR. BRIAN J BLAKE |
| Credential | M.D. |
| Practice Address |
4760 Belpar St Nw Canton OH 44718-3603 |
| Practice Telephone | 3304929200 |
| Practice Fax Number | 3304925454 |
| Mailing Telephone | 3304929200 |
| Mailing Fax Number | 3304925454 |
| Enumeration Date | 2008-09-20 |
| Last Update Date | 2011-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 35095075 | OH | Allopathic & Osteopathic Physicians |
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A106986 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891819405 | Brian Eugene Blake | Internal Medicine | 7916 E Commercial St, Broken Arrow, OK 74014-2683 | 2007-03-19 |
| 1295078608 | Brian William Blake | Emergency Medicine | 290 N Wayte Ln # 1800, Fresno, CA 93701-2124 | 2013-04-03 |
| 1952578064 | Brian Kelly Blake | Emergency Medicine | 1717 Main St, Suite 5200, Dallas, TX 75201-4612 | 2008-05-08 |
| Street Address |
4760 BELPAR ST NW |
| City | CANTON |
| State | OH |
| Zip Code | 44718-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093705063 | Daniel Alexander Charlick | Orthopaedic Surgery | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2005-10-21 |
| 1215535885 | Ashley Norman | Physician Assistant | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2020-10-15 |
| 1689146367 | Taylor Mattioli | Physician Assistant | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2018-12-19 |
| 1598234080 | Ceceilia Nichole Kissel | Physician Assistant | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2018-11-14 |
| 1023594835 | Kristen N Scali | Physical Therapist | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2018-07-15 |
| 1760970479 | Bonnie Austin | Nurse Practitioner | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2018-04-27 |
| 1720519424 | David Allen Stearns | Nurse Practitioner | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2017-03-23 |
| 1225402720 | Laurie Reiner | Specialist/Technologist | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2015-11-20 |
| 1083057392 | Meghan Elizabeth Nein | Pain Medicine | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2013-04-17 |
| 1730429275 | Kelsey S O'connor | Physical Medicine & Rehabilitation | 4760 Belpar St Nw, Canton, OH 44718-3603 | 2013-02-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639658057 | Christine Lynn Mccrone | Psychologist | 4450 Belden Village St Nw Ste 701, Canton, OH 44718 | 2018-08-07 |
| 1295252500 | Dora C Holliday | Student in an Organized Health Care Education/Training Program | 4641 Fulton Dr N.w., Canton, OH 44718 | 2017-08-28 |
| 1770035487 | A B A Let's Play, Inc. | Community/Behavioral Health | 6304 Shipslanding Ave Nw, Canton, OH 44718 | 2016-10-28 |
| 1457710139 | Aria Lg Counseling and Wellness Center, LLC | Clinic/Center | 5262 Fulton Road Nw, Canton, OH 44718 | 2016-02-23 |
| 1457722365 | Melinda R Bond | Nurse Practitioner | 4105 Holiday Street Nw, Canton, OH 44718 | 2015-10-19 |
| 1164804860 | Ashley Marie Whetsell | Dentist | 4550 Belden Village Street Nw, Canton, OH 44718 | 2015-06-18 |
| 1346643749 | Emil D. Poporad, Dds | Dentist | 4124 Fulton Rd. N.w., Suite 102, Canton, OH 44718 | 2014-09-30 |
| 1699198390 | Lauri Sanders | Social Worker | 5860 Fulton Dr Nw, Canton, OH 44718 | 2014-01-31 |
| 1376893768 | Courteney R Briceland | Social Worker | 4641 Fulton Rd. Nw, Canton, OH 44718 | 2012-09-13 |
| 1982953220 | Lyudmyla Z Rockaway | Marriage & Family Therapist | 4895 Dressler Road Nw, Ste A, Canton, OH 44718 | 2012-08-31 |
| Find all providers in zip 44718 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104442516 | Beacon Orthopaedics & Sports Medicine, Ltd | Orthopaedic Surgery | 100 Arrow Springs Blvd Ste 2600, Lebanon, OH 45036-7021 | 2020-06-22 |
| 1790281517 | Mercy Health Physicians Cincinnati LLC | Orthopaedic Surgery | 6770 Cincinnati Dayton Rd Ste 110, Liberty Township, OH 45044-9319 | 2018-04-02 |
| 1952817413 | Caitlin Elisabeth Lefevre | Orthopaedic Surgery | 1000 Regency Ct Ste 212, Toledo, OH 43623-3091 | 2017-12-20 |
| 1255740197 | Orthocincy | Orthopaedic Surgery | 440 Corwin Nixon Blvd, South Lebanon, OH 45065-1196 | 2014-08-05 |
| 1427465517 | Anthony Stephen Berdis | Orthopaedic Surgery | 1695 Niles Cortland Road Ne Ste 2, Warren, OH 44484 | 2014-07-21 |
| 1831525500 | Mccullough-hyde Memorial Hospital, Inc. | Orthopaedic Surgery | 5151 Morning Sun Rd Ste A, Pinnacle Orthopaedics & Sports Medicine, Oxford, OH 45056-9546 | 2013-09-25 |
| 1699020206 | Benjamin D. Richman | Orthopaedic Surgery | 245 Meadowood Ln, Moreland Hills, OH 44022-1342 | 2012-07-19 |
| 1083945638 | Orthocincy | Orthopaedic Surgery | 7626 University Dr, Suite 102, West Chester, OH 45069-2509 | 2010-01-21 |
| 1669602140 | David Alan Brys | Orthopaedic Surgery | 2785 Timbercreek Dr N, Cortland, OH 44410 | 2009-07-20 |
| 1730314238 | Ian Sterling Rice | Orthopaedic Surgery | 4030 Smith Rd Ste 350, Cincinnati, OH 45209-1969 | 2009-05-28 |
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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.