DR. KEITH BRADLEY BLAYLOCK (NPI# 1326593674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326593674 |
| Entity Type | Individual |
| Full Name | DR. KEITH BRADLEY BLAYLOCK |
| Credential | PT, DPT, OCS, ATC |
| Practice Address |
825 Centennial Dr Chadron NE 69337-9400 |
| Practice Telephone | 3084320232 |
| Practice Fax Number | 3084320268 |
| Mailing Telephone | 3084320232 |
| Mailing Fax Number | 3084320268 |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-08-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
1059 | NE | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
825 CENTENNIAL DR |
| City | CHADRON |
| State | NE |
| Zip Code | 69337-9400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912980327 | Jerry L Mclain | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2005-11-21 |
| 1174145502 | Madison Elisabeth Nitsch | Specialist/Technologist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2020-05-07 |
| 1639717135 | Leah A Frye | Pharmacist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2019-12-15 |
| 1194370007 | Emily M Arterburn | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2019-08-07 |
| 1619455946 | Chadron Medical Clinic PC | Family Medicine | 825 Centennial Dr, Chadron, NE 69337 | 2018-07-30 |
| 1619479698 | Kaelyse Noel Adler | Physician Assistant | 825 Centennial Dr, Chadron, NE 69337-9400 | 2018-03-06 |
| 1992217988 | Aimy Irenaeia Mahony | Family Medicine | 825 Centennial Dr, Chadron, NE 69337-9400 | 2017-10-30 |
| 1427502897 | Eser Graham-marski | Physical Therapist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-15 |
| 1174076657 | Sarah Wirth | Physical Therapy Assistant | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-01 |
| 1962955443 | Jera Lynn Boeselager | Physical Therapist | 825 Centennial Dr, Chadron, NE 69337-9400 | 2016-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720507759 | Tracey Linn Wilson | Case Manager/Care Coordinator | 300 Shelton Street, Chadron, NE 69337 | 2017-09-11 |
| 1962668491 | Mental Health Care Assoc | Counselor | 343 Chadron Ave, Chadron, NE 69337 | 2008-08-04 |
| 1396901898 | Desiree Dawn Moreland | Pharmacist | 825 Centennial Drive, Chadron, NE 69337 | 2008-08-04 |
| 1336360684 | Joan M. Yekel | Counselor | 651 West 4th Street, Chadron, NE 69337 | 2007-05-02 |
| 1003030065 | Sonja Lynne Dressel | Counselor | 301 West 2nd St, Chadron, NE 69337 | 2007-04-12 |
| 1689798308 | Rebecca Ann Brost | Counselor | 301 West 2nd Street, Chadron, NE 69337 | 2007-03-19 |
| 1679638472 | Teena Ionne Kenrick | Counselor | 318 Shelton St, Chaoron, NE 69337 | 2006-12-22 |
| 1861560666 | Margaret K Griffith | Counselor | 327 Ann St, Chadron, NE 69337 | 2006-12-01 |
| 1386715654 | Affinity Therapy Associates LLC | Counselor | 327 Ann Street, Chadron, NE 69337 | 2006-11-10 |
| 1093724650 | Apria Healthcare LLC | Durable Medical Equipment & Medical Supplies | 625 West 3rd Street, Chadron, NE 69337 | 2006-08-05 |
| Find all providers in zip 69337 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992311997 | Paul Hoppmann | Physical Therapist | 3537 N 162nd Ct, Omaha, NE 68116 | 2020-09-16 |
| 1659742047 | C.o.r.e. Physical Therapy and Sports Performance PC | Physical Therapist | 17660 Wright St # St910, Omaha, NE 68130-2102 | 2015-10-12 |
| 1922445741 | Sally Ann Snyder | Physical Therapist | 1904 N 172nd Cir, Omaha, NE 68118-2897 | 2013-06-03 |
| 1598914301 | Ross Ryan Holsing | Physical Therapist | 12565 West Center Road, Suite 130, Omaha, NE 68144 | 2008-09-17 |
| 1578725677 | Claire Renee Lakatos-rathjen | Physical Therapist | 17660 Wright St, Suite 9/10, Omaha, NE 68130-2102 | 2008-06-30 |
| 1861692055 | Jeffrey Lee Arnold | Physical Therapist | 8419 S 73rd Plz Ste 104, Papillion, NE 68046-1507 | 2007-07-25 |
| 1801014121 | Rachelle Marie Mcguigan | Physical Therapist | 4006 N 144th St, Omaha, NE 68116-4206 | 2007-04-23 |
| 1497820567 | Sean M Vonderfecht | Physical Therapist | 223 E 14th St Ste 40, Hastings, NE 68901-3240 | 2006-11-22 |
| 1447335161 | Nicholas Garrett Wegener | Physical Therapist | 13809 Industrial Rd, Omaha, NE 68137-1117 | 2006-10-25 |
| 1528174711 | John M Linn | Physical Therapist | 1651 N. 86th Street, Suite 100, Lincoln, NE 68505-3719 | 2006-08-22 |
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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.