NICHOLAS ZOLTAN BLAKE (NPI# 1811300999) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811300999 |
| Entity Type | Individual |
| Full Name | NICHOLAS ZOLTAN BLAKE |
| Credential | MD |
| Practice Address |
76 Ne 12th St Madras OR 97741-1827 |
| Mailing Address |
2385 Ne Hilltop Ln Madras OR 97741-8733 |
| Practice Telephone | 4062584789 |
| Practice Fax Number | 4062584732 |
| Mailing Telephone | (406) 258-4789 |
| Mailing Fax Number | 4062584732 |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2017-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD184258 | OR | Allopathic & Osteopathic Physicians |
| Street Address |
76 NE 12TH ST |
| City | MADRAS |
| State | OR |
| Zip Code | 97741-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518964600 | Thomas Martin Manning | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2005-07-05 |
| 1083236442 | Physician Management Services of Oregon, LLC | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2020-05-08 |
| 1083154470 | Molly Nichols | Physician Assistant | 76 Ne 12th St, Madras, OR 97741 | 2017-03-03 |
| 1104379403 | Katherine Volk | Physician Assistant | 76 Ne 12th St, Madras, OR 97741-1827 | 2016-08-03 |
| 1760847057 | Joshua Burns | Physician Assistant | 76 Ne 12th St, Madras, OR 97741-1827 | 2015-12-31 |
| 1902018757 | Kristine Marie Delamarter | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2007-05-04 |
| 1174687867 | Karen V Potampa | Nurse Practitioner | 76 Ne 12th St, Madras, OR 97741-1827 | 2006-12-20 |
| 1467407122 | Keith Eugene Long | Physician Assistant | 76 Ne 12th St, Madras, OR 97741-1827 | 2006-05-23 |
| 1679526552 | Douglas W Lieuallen | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2006-05-19 |
| 1417900317 | Gary M Plant | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2006-05-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750868196 | Orie Made | Counselor | 185 Nw D St, Suite D&e, Madras, OR 97741 | 2018-07-27 |
| 1831514603 | Robbin Webber Foster | Social Worker | 470 Ne 'a' St., St. Charles Hospice, Madras, OR 97741 | 2014-03-03 |
| 1184055931 | Sue Lillian Dixon | Nurse Practitioner | 715 S.w. 4th St., Ste.c, Madras, OR 97741 | 2013-12-04 |
| 1255769667 | Aaron Michael Lee | Physician Assistant | 76 N.e. 12th St., Madras, OR 97741 | 2013-10-22 |
| 1114276045 | April A Henselman Campanella | Dental Hygienist | 376 Ne Oak Street, Madras, OR 97741 | 2012-09-06 |
| 1487809091 | Bestcare Treatment Services | Substance Abuse Rehabilitation Facility | 125 Sw C Street, Madras, OR 97741 | 2008-11-24 |
| 1144417437 | Assisted Living Concepts Inc | Assisted Living Facility | 470 Ne Oak Street, Madras, OR 97741 | 2007-10-01 |
| 1518074327 | Janice K Monroe | Nurse Practitioner | 910 Sw Hwy 97, Suite 101, Madras, OR 97741 | 2006-08-25 |
| 1215966759 | Mark M Mullins | Chiropractor | 28 Ne 12th St, Madras, OR 97741 | 2006-06-30 |
| 1356389894 | St. Charles Health System, Inc. | Emergency Medicine | 470 Ne A Street, Madras, OR 97741 | 2006-06-04 |
| Find all providers in zip 97741 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598866972 | Kim Ray Montee | Family Medicine | 850 Sw 4th St Ste 101, Madras, OR 97741-9629 | 2006-09-26 |
| 1518964600 | Thomas Martin Manning | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2005-07-05 |
| 1083236442 | Physician Management Services of Oregon, LLC | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2020-05-08 |
| 1316365992 | Leslie Mccalister | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2014-04-01 |
| 1740570266 | Jinnell Ann Lewis | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2011-04-18 |
| 1770801235 | Aimee Marie Neill | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2010-05-08 |
| 1902018757 | Kristine Marie Delamarter | Family Medicine | 76 Ne 12th St, Madras, OR 97741-1827 | 2007-05-04 |
| 1265659510 | William P Irvine | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2007-04-19 |
| 1932227105 | Mountain View Hospital District | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2007-03-27 |
| 1679637201 | Nicholas T Turek | Family Medicine | 480 Ne A St, Madras, OR 97741-1844 | 2006-12-20 |
| Find all providers in MADRAS | ||||
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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.