JAMES L BLAINE (NPI# 1801963459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801963459 |
| Entity Type | Individual |
| Full Name | JAMES L BLAINE |
| Credential | P.A.-C |
| Practice Address |
765 S Utah Ave Idaho Falls ID 83402-5093 |
| Practice Telephone | 2085252600 |
| Practice Fax Number | 2085252611 |
| Mailing Telephone | 2085252600 |
| Mailing Fax Number | 2085252611 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2010-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-353 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | MEDICARE PTAN | 1667204 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386737526 | James Read Blaine | Family Medicine | 815 N Sherman Ave, Suite 208, Springfield, MO 65802-3757 | 2006-10-02 |
| 1942304027 | James Eldridge Blaine Jr. | Podiatrist | 355 E Campus View Blvd, Suite 175, Columbus, OH 43235-5616 | 2006-09-11 |
| 1538155494 | James A Blaine | Podiatrist | 104 Technology Dr, Suite 103, Butler, PA 16001-1801 | 2005-09-26 |
| Street Address |
765 S UTAH AVE |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83402-5093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306865464 | Derek R Campbell | Family Medicine | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2006-07-19 |
| 1295009785 | Community Care West Side LLC | Family Medicine | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2012-02-29 |
| 1164584074 | Caren J Smith | Physician Assistant | 765 S Utah Ave, Idaho Falls, ID 83402-5093 | 2006-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648015 | Abigail Oakley | Counselor | Tueller Counseling Services, 2275 W Broadway Suite G, Idaho Falls, ID 83402 | 2020-10-30 |
| 1265041479 | Fresenius Medical Care Snake River | Clinic/Center | 3195 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-24 |
| 1295352391 | Fresenius Medical Care Idaho Falls, LLC | Clinic/Center | 3193 South Fork Blvd, Idaho Falls, ID 83402 | 2020-07-06 |
| 1952923765 | Sterling Provider Group | Clinic/Center | 7017 Daisy Lane, Idaho Falls, ID 83402 | 2020-05-14 |
| 1528604188 | Leslie Hendrian | Massage Therapist | 86 N Kaylee Circle, Idaho Falls, ID 83402 | 2019-11-19 |
| 1154966760 | Christine Nicole Cardona | Counselor | 855 N. Captital Ave Ste 1, Idaho Falls, ID 83402 | 2019-11-07 |
| 1750847786 | Brandi S Warnke | Social Worker | 254 E Street, Suite B, Idaho Falls, ID 83402 | 2019-02-14 |
| 1013402809 | Kailey Lynn Moore | Pharmacist | 376 West 18th Street, Idaho Falls, ID 83402 | 2018-06-25 |
| 1407368616 | Jessica Owsley | Social Worker | 2275 W Broadway Ste G, Idaho Falls, ID 83402 | 2017-10-27 |
| 1427419886 | Becky Allen | Developmental Therapist | 150 Shoupe Ave, Idaho Falls, ID 83402 | 2016-03-14 |
| Find all providers in zip 83402 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386743862 | David Dean Buys | Physician Assistant | 3614 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2006-09-21 |
| 1316910797 | Stephanie Morgan | Physician Assistant | 1660 John Adams Pkwy, Idaho Falls, ID 83401-4360 | 2006-02-08 |
| 1386626463 | Wade K Christensen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-15 |
| 1851396519 | Jamie L Carter | Physician Assistant | 3100 Channing Way, Idaho Falls, ID 83404-7533 | 2005-06-17 |
| 1609492347 | Jason T Rinker | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2020-06-18 |
| 1821645870 | Benjamin J Atwood | Physician Assistant | 3446 S 15th E, Idaho Falls, ID 83404-8262 | 2019-08-23 |
| 1134647019 | Randall James Law | Physician Assistant | 1995 E 17th St, Idaho Falls, ID 83404-6493 | 2017-08-31 |
| 1144772237 | Alyssa Jenkins | Physician Assistant | 3820 Crestwood Ln, Idaho Falls, ID 83404 | 2016-10-25 |
| 1093103699 | Tara Powell | Physician Assistant | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2015-01-05 |
| 1235568742 | Shelley Leilani Davis | Physician Assistant | 3614 Washington Pkwy, Idaho Falls, ID 83404-7573 | 2013-11-05 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83402 |
Please comment or provide details below to improve the information on JAMES L BLAINE.
| 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.