MR. JACK COLT BLAINE (NPI# 1811999642) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811999642 |
| Entity Type | Individual |
| Full Name | MR. JACK COLT BLAINE |
| Credential | CRNA |
| Practice Address |
1788 Zafiro Ct Palm Springs CA 92264-6808 |
| Practice Telephone | 6199942941 |
| Mailing Telephone | 6199942941 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2016-07-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367500000X | Nurse Anesthetist, Certified Registered | NA1771 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | R53959 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | R0057403 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 440288/1771 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | 647024 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| N | 367500000X | Nurse Anesthetist, Certified Registered | RN045300 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720139199 | Jack D Blaine | Psychiatry & Neurology | 4400 E West Hwy, Suite 225, Bethesda, MD 20814-4524 | 2007-01-14 |
| Street Address |
1788 ZAFIRO CT |
| City | PALM SPRINGS |
| State | CA |
| Zip Code | 92264-6808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928679 | Carina Lopez | Technician, Other | 3065 E Ramon Rd, Palm Springs, CA 92264 | 2020-10-07 |
| 1538727466 | Sina Khanbabakhani | Dentist | 555 South Sunrise Way, Palm Springs, CA 92264 | 2019-06-05 |
| 1265971162 | Mark Jordan Agresor | Assisted Living Facility | 4425 Camino Parocela, Palm Springs, CA 92264 | 2017-02-13 |
| 1609329002 | Jeffrey Idica | Naturopath | 1775 E Palm Canyon Dr Ste 310, Palm Springs, CA 92264 | 2016-08-02 |
| 1609240605 | Brandon Hagar | Technician, Other | 3025 E Escoba Dr Apt 236, Palm Springs, CA 92264 | 2015-11-14 |
| 1861618852 | Jin Woo | Acupuncturist | 1001 S Palm Canyon Dr, Suite 105, Palm Springs, CA 92264 | 2007-04-18 |
| 1629114269 | Andrew Petras | Optometrist | 148 Eastlake Dr, Palm Springs, CA 92264 | 2007-01-30 |
| 1952453375 | Gina D Davis | Chiropractor | 4050 Airport Center Drive, Suite G, Palm Springs, CA 92264 | 2007-01-17 |
| 1548328834 | Michael R Gurk Ms Pt Apc | Physical Therapist | 1001 S Palm Canyon Drive, Ste 111, Palm Springs, CA 92264 | 2006-12-05 |
| 1750399747 | Lee Un A Professional Dental Corp | Dentist | 471 E Tahquitz Cyn Way #221, Palm Springs, CA 92264 | 2006-08-04 |
| Find all providers in zip 92264 | ||||
| Taxonomy Code | 367500000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Anesthetist, Certified Registered |
| (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. |
| Notes: Sources: (1) Council on Certification of Nurse Anesthetists, Park Ridge, IL, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. (2) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 548. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538529649 | Jennifer Laurin | Nurse Anesthetist, Certified Registered | 291 Calle Tranquillo, Palm Springs, CA 92262-5106 | 2016-03-02 |
| 1811309669 | Cristina Coolidge | Nurse Anesthetist, Certified Registered | 392 E Stevens Rd, J12, Palm Springs, CA 92262-4755 | 2014-05-28 |
| 1700402005 | Joel T Comer | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2020-06-23 |
| 1821618778 | Nina Nhu-y Duong Nguyen | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2020-04-21 |
| 1760971063 | Rachel Ann Reidinger | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2018-05-02 |
| 1518467802 | Jesus Ernesto Varela | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2018-02-13 |
| 1851836670 | Andrew Silvestri | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2017-01-03 |
| 1386016087 | Desert Cities Anesthesia Professionals | Nurse Anesthetist, Certified Registered | 1180 N Indian Canyon Dr, Suite 110, Palm Springs, CA 92262-4800 | 2015-10-21 |
| 1669863809 | Mikhail Nizamov | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2015-02-10 |
| 1801190434 | Ty Jacob Newman | Nurse Anesthetist, Certified Registered | 1150 N Indian Canyon Dr, Palm Springs, CA 92262-4872 | 2010-12-21 |
| Find all providers in PALM SPRINGS | ||||
| City | PALM SPRINGS |
| Zip Code | 92264 |
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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.