JACOB BLASINGAME (NPI# 1720619232) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720619232 |
| Entity Type | Individual |
| Full Name | JACOB BLASINGAME |
| Credential | PA-C |
| Practice Address |
2300 S 1st St Champaign IL 61820-7661 |
| Mailing Address |
108 Burwash Ave Apt B Savoy IL 61874-8700 |
| Practice Telephone | 2173839400 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 085007530 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2300 S 1ST ST |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61820-7661 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679530836 | Cathy L Borst | Occupational Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2006-04-28 |
| 1578110607 | Kathleen Morrison | Specialist/Technologist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-08-22 |
| 1609423904 | Lauren A Henderson | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-08-21 |
| 1689237554 | Nicholas Allen Pippin | Specialist/Technologist | 2300 S 1st St, Champaign, IL 61820-7661 | 2019-04-17 |
| 1154803351 | Christopher Nguyen | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2018-09-04 |
| 1902310642 | Julie A Shain | Nurse Practitioner | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-11-16 |
| 1851818942 | April M Shaw | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-08-29 |
| 1629594825 | Adam T Carver | Physical Therapist | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-08-18 |
| 1053850586 | Alger Penas | Nurse Practitioner | 2300 S 1st St, Champaign, IL 61820-7661 | 2017-02-16 |
| 1134520539 | Jariah Fulson | Specialist/Technologist | 2300 S 1st St, Champaign, IL 61820-7661 | 2014-09-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982217345 | Costco Wholesale Corporation | Pharmacy | 2002 N. Neil St., Champaign, IL 61820 | 2020-08-26 |
| 1255963583 | Jamey Richard Bailey | Social Worker | 701 Devonshire Drive, Bldg C, Suite 206, C-6, Champaign, IL 61820 | 2020-02-05 |
| 1790247443 | Jason Abrams | Counselor | 201 W Springfield Ave., Suite 1002-1003, Champaign, IL 61820 | 2019-04-02 |
| 1184100273 | Janine Rafferty | Pharmacist | 2002 N Neil St, Champaign, IL 61820 | 2018-07-12 |
| 1417475070 | Brodbeck Counseling, PC | Community/Behavioral Health | 301 N. Neil Street Suite 323, Champaign, IL 61820 | 2017-09-05 |
| 1447773726 | Quanata M Pelmore | Nurse's Aide | 508 E. Vine St, Champaign, IL 61820 | 2017-07-19 |
| 1821518127 | Molly Mclay | Social Worker | 309 W Clark St., Champaign, IL 61820 | 2017-06-27 |
| 1396265849 | Lou Echols Chambers | Audiologist | 901 South Sixth Street, Chamapign, IL 61820 | 2017-06-26 |
| 1962874495 | Luciana Angelica Guardini | Social Worker | 100 North Chestnut Street, Suite 244, Champaign, IL 61820 | 2015-10-23 |
| 1538544465 | Cpo Services, Inc. | Prosthetic/Orthotic Supplier | 410 E University Ave Ste 105, Champaign, IL 61820 | 2015-07-21 |
| Find all providers in zip 61820 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992134241 | Heather Michelle Nobles | Physician Assistant | 2408 Heathrow Dr, Apartment 14, Champaign, IL 61820-2385 | 2013-11-07 |
| 1720066251 | Heather Konzelmann | Physician Assistant | 1801 Windsor Rd, Champaign, IL 61822-6217 | 2006-01-05 |
| 1598752628 | Kori L Carroll | Physician Assistant | 3105 Fields South Dr, Champaign, IL 61822-3743 | 2005-10-04 |
| 1376544585 | Brian Neal Shore | Physician Assistant | 2110 Fox Dr, Champaign, IL 61820-7553 | 2005-08-10 |
| 1376166264 | Carlos Rodolfo Bocanegra Cordova | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-05-26 |
| 1992324941 | Ryan Jordan Minier | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2020-04-10 |
| 1790320802 | Amy Beth Kutska | Physician Assistant | 101 W University Ave, Champaign, IL 61820-3981 | 2019-11-12 |
| 1316592637 | Carrie Elizabeth Keenan | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2019-08-04 |
| 1093283954 | River Andres | Physician Assistant | 819 Bloomington Rd, Champaign, IL 61820-2101 | 2018-11-08 |
| 1730580572 | Stephanie Zuber | Physician Assistant | 101 W University Ave, Champaign, IL 61820-3909 | 2014-09-11 |
| Find all providers in CHAMPAIGN | ||||
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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.