BLAKE PETERSON (NPI# 1689027054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689027054 |
Entity Type | Individual |
Full Name | BLAKE PETERSON |
Credential | DPM |
Practice Address |
8130 Hawthorn Temple TX 76502 |
Mailing Address |
Po Box 26559 Prescott Valley AZ 86312-6559 |
Practice Telephone | 4803388552 |
Mailing Telephone | 9284454898 |
Enumeration Date | 2016-07-20 |
Last Update Date | 2019-08-01 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 213E00000X | Podiatrist | T60-2016 | TX | Podiatric Medicine & Surgery Service Providers |
Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
000930 | AZ | Podiatric Medicine & Surgery Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942200159 | Blake Allen Peterson | Optometrist | 2020 Keith St Nw, Cleveland, TN 37311-1351 | 2005-07-29 |
1962965855 | Blake Peterson | Chiropractor | 1878 W 3600 S, West Valley City, UT 84119-3893 | 2019-04-09 |
1821506601 | Blake Richard Peterson | Massage Therapist | 3536 Grove Ave, Richmond, VA 23221-2200 | 2018-01-16 |
1043561343 | Blake T Peterson | Nurse Anesthetist, Certified Registered | 406 S 30th Ave, Suite 202, Yakima, WA 98902-3713 | 2012-09-26 |
1023379849 | Blake Peterson | Orthopaedic Surgery | 2445 Army Navy Dr, Arlington, VA 22206-2905 | 2012-06-07 |
Street Address |
8130 HAWTHORN |
City | TEMPLE |
State | TX |
Zip Code | 76502 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
Find all providers in zip 76502 |
Taxonomy Code | 213ES0103X |
Grouping | Podiatric Medicine & Surgery Service Providers |
Classification | Podiatrist |
Specialization | Foot & Ankle Surgery |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134658453 | Lily Raga | Podiatrist | 2601 Thornton Ln Ste 200, Temple, TX 76502-1808 | 2017-06-08 |
1295186856 | John Andrew Yuhas | Podiatrist | 2601 Thornton Ln Ste 2601, Temple, TX 76502-1808 | 2016-06-24 |
1255338992 | Christopher Glenn Browning | Podiatrist | 2601 Thornton Ln, Temple, TX 76502-1808 | 2005-07-07 |
1699126961 | Himani Patel | Podiatrist | 2401 S 31st St, Temple, TX 76508-0001 | 2016-06-28 |
1992188452 | Evangelos Kyprios | Podiatrist | 2601 Thornton Ln, 200, Temple, TX 76502-1808 | 2015-07-01 |
1710392279 | Lanster Rusk Martin | Podiatrist | 2601 Thornton Ln, Temple, TX 76502-1808 | 2014-06-24 |
1194130880 | Jonathan Lorenzana | Podiatrist | 2601 Thornton Ln, Temple, TX 76502-1808 | 2014-06-22 |
1598053910 | Rebecca Suzan Smith | Podiatrist | 2601 Thornton Ln, Attn: Rebecca Smith, Dept of Podiatry, Temple, TX 76502-1808 | 2011-07-19 |
1598081259 | Muhlenberg Family Footcare Ltd | Podiatrist | 4148 Kutztown Rd, Temple, PA 19560-1900 | 2010-04-20 |
1053570317 | John A Brust | Podiatrist | 2401 S 31st St, Temple, TX 76508-0001 | 2008-06-03 |
Find all providers in TEMPLE |
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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.