DR. KIMBERLY BLAKE (NPI# 1265480222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265480222 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY BLAKE |
| Credential | M.D. |
| Practice Address |
96 Colchester Ave Burlington VT 05401-1417 |
| Practice Telephone | 8026580505 |
| Mailing Telephone | 8026580505 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-01-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 302048 | NY | Allopathic & Osteopathic Physicians |
| N | 207V00000X | Obstetrics & Gynecology | 0420008805 | VT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 0VN0812 | 05 | |
| VT | RAIL ROAD MEDICARE | 160050512 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 855 Pine St, Burlington, VT 054014924 | 8024886000 | |
| 75 San Remo Dr, South Burlington, VT 054036385 | 8024886000 | 8024886919 |
| 75 Beekman St, Plattsburgh, NY 129011438 | 5185612000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689626319 | Kimberly A Blake | Nurse Practitioner | 106 Calvert St, Harrison, NY 10528-3131 | 2006-05-17 |
| 1790391530 | Kimberly Blake | Chore Provider | 1325 Airmotive Way, Reno, NV 89502-3201 | 2020-09-17 |
| 1811306418 | Kimberly Blake | Technician, Other | 815 W 5th North St, Morristown, TN 37814-3810 | 2014-08-07 |
| 1265715858 | Kimberly Blake | Case Manager/Care Coordinator | 6701 Hwy 67 S, Bldg 4, Benton, AR 72015 | 2011-09-21 |
| 1689971749 | Kimberly Lorene Blake | Nurse Practitioner | 1125 Skyline Dr, Conway, AR 72032-6657 | 2011-02-24 |
| 1295030195 | Kimberly Thornton Blake | Physician Assistant | 1401 W Seminole Blvd, Sanford, FL 32771-6743 | 2011-01-24 |
| Street Address |
96 COLCHESTER AVE |
| City | BURLINGTON |
| State | VT |
| Zip Code | 05401-1417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104884824 | Affiliates In Obstetrical & Gynecological Care Inc | Clinic/Center | 96 Colchester Ave, Burlington, VT 05401-1417 | 2006-05-02 |
| 1710306535 | Kelly Ann Mccaffrey | Obstetrics & Gynecology | 96 Colchester Ave, Burlington, VT 05401-1417 | 2014-04-09 |
| 1205275070 | Alexandra Charlotte Fenton | Obstetrics & Gynecology | 96 Colchester Ave, Burlington, VT 05401-1417 | 2013-06-14 |
| 1487872925 | Greta Elizabeth Hanson | Obstetrics & Gynecology | 96 Colchester Ave, Affiliates In Ob/gyn, Burlington, VT 05401-1417 | 2007-04-22 |
| 1922034479 | Dale Jeanne Lacroix | Obstetrics & Gynecology | 96 Colchester Ave, Burlington, VT 05401-1417 | 2006-06-25 |
| 1720036783 | Patrick Clifford | Obstetrics & Gynecology | 96 Colchester Ave, Burlington, VT 05401-1417 | 2006-05-04 |
| 1962450957 | Suzanne Scharf | Nurse Practitioner | 96 Colchester Ave, Burlington, VT 05401-1417 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821626748 | John Henry Priester Jr. | Student in an Organized Health Care Education/Training Program | University of Vermont Medical Center, 111 Colchester Avenue, Burlington, VT 05401 | 2020-03-27 |
| 1730649054 | Parisa Heidari | Student in an Organized Health Care Education/Training Program | Uvmmc 111 Colchester Avenue, Burlington, VT 05401 | 2019-03-22 |
| 1689141988 | No Diet Dietitian, LLC | Dietitian, Registered | 163 Bayberry Circle #204, Burlington, VT 05401 | 2018-10-25 |
| 1073097267 | Katherine Dwyer | Physical Therapist | 128 Lakeside Ave, Burlington, Vt, 05401, Burlington, VT 05401 | 2018-09-24 |
| 1710469481 | Nicholas A Fredette | Nurse Practitioner | 28 S. Williams St., Burlington, VT 05401 | 2018-08-30 |
| 1760987473 | Tyler Fanning | Psychiatry & Neurology | Uvmmv 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-26 |
| 1356845416 | Rachel Carlson | Student in an Organized Health Care Education/Training Program | Uvmmc, 111 Colchester Avenue, Burlington, VT 05401 | 2018-03-22 |
| 1487152096 | Garnet Transport Medicine, LLC | Ambulance | 70 S Winooski Ave Ste 255, Burlington, VT 05401 | 2018-01-29 |
| 1689172660 | Valerie Goldberg | Dietitian, Registered | 163 Bayberry Circle Apt 204, Burlington, VT 05401 | 2018-01-25 |
| 1548774235 | Emily R Day | Physical Therapist | 160 Flynn Avenue, Burlington, VT 05401 | 2017-11-17 |
| Find all providers in zip 05401 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821382482 | Jacqueline Marie Carpenter | Obstetrics & Gynecology | 6105 1st Financial Dr, Burlington, KY 41005-7892 | 2011-06-01 |
| 1548428964 | Stephen Daniel Jackson | Obstetrics & Gynecology | 1091 Kirkpatrick Road, Burlington, NC 27215-9714 | 2008-06-02 |
| 1871786673 | Grace Womens Clinic Pa | Obstetrics & Gynecology | 2280 S Church St Ste 201, Suite 201, Burlington, NC 27215-5397 | 2007-08-24 |
| 1871672923 | Susan M Hagnell | Obstetrics & Gynecology | 248 Mchenry Street, Burlington, WI 53105 | 2006-11-02 |
| 1598861791 | Robert Siefring | Obstetrics & Gynecology | 1900 Burlington Mount Holly Rd Ste D, Burlington Professional Campus (rte 541), Burlington, NJ 08016-4722 | 2006-09-15 |
| 1518926245 | Peter J Rotolo | Obstetrics & Gynecology | 101 Cambridge Street, Burlington, MA 01803 | 2006-03-21 |
| 1073510665 | Philip John Rosenow | Obstetrics & Gynecology | 1091 Kirkpatrick Rd, Burlington, NC 27215-9714 | 2005-06-28 |
| 1942826995 | Healthone Clinic Services - Obstetrics and Gynecology LLC | Obstetrics & Gynecology | 286 16th St, Burlington, CO 80807-1651 | 2020-06-24 |
| 1013450840 | Jessica Ryniec | Obstetrics & Gynecology | 111 Colchester Ave, Uvm Medical Center- Obstetrics and Gynecology, Burlington, VT 05401 | 2016-11-28 |
| 1033666441 | Ankita Kulkarni | Obstetrics & Gynecology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2016-09-01 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 05401 |
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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.