Kevin K Blake (NPI# 1174957864, PAC ID# 1759518509) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1174957864 |
| PAC ID by PECOS | 1759518509 |
| Professional Enrollment ID | I20131226000636 |
| Full Name | Kevin K Blake |
| Organization Legal Name | WELLMONT MEDICAL ASSOCIATES INC |
| Address |
2202 N John B Dennis Hwy Suite 100 Kingsport TN 37660-5904 |
| Phone Number | 4235788500 |
| Gender | M |
| Medical School | EAST TENNESSEE STATE UNIVERSITY, QUILLEN-DISHNER COLLEGE OF MEDICINE |
| Graduation Year | 1992 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 8123291739 |
| Number of Group Practice Members | 296 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440176 | INDIAN PATH MEDICAL CENTER |
| 440017 | WELLMONT HOLSTON VALLEY MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 2202 N John B Dennis Hwy, Suite 100, Kingsport, TN 37660-5904 | 4235788500 | WELLMONT MEDICAL ASSOCIATES INC |
| Organization Legal Name | WELLMONT MEDICAL ASSOCIATES INC |
| Physicians | 303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shirley J Davis | Nurse Practitioner | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Kingsport, TN 37660-5904 |
| Crystal L Stiltner | Family Medicine | Wellmont Medical Associates Inc | 405 Scenic Dr, Suite B, Rogersville, TN 37857-2441 |
| April A Wallace | Nurse Practitioner | Wellmont Medical Associates Inc | 671 Hwy 58 E, Norton, VA 24273-3007 |
| Jared Charles Abel | Nurse Practitioner | Wellmont Medical Associates Inc | 410 Stagecoach Rd, Bristol, VA 24201-8359 |
| Pamela Kelli Lane | Nurse Practitioner | Wellmont Medical Associates Inc | 2830 Hwy 394, Suite 4, Blountville, TN 37617-5577 |
| Jonathan M. Hutchins | Nurse Practitioner | Wellmont Medical Associates Inc | 310 3rd St Ne, Norton, VA 24273-1137 |
| Keressa L Clark | Nurse Practitioner | Wellmont Medical Associates Inc | 1220 Volunteer Pkwy, Bristol, TN 37620-4628 |
| Kayla J Joyce | Nurse Practitioner | Wellmont Medical Associates Inc | 115 Judge Gresham Rd, Gray, TN 37615-6213 |
| Morgan Cabell | Nurse Practitioner | Wellmont Medical Associates Inc | 2686 W State St, Bristol, TN 37620-1817 |
| Kevin Hudson | Physician Assistant | Wellmont Medical Associates Inc | 410 N State of Franklin Rd, Suite 140, Johnson City, TN 37604-6035 |
| Street Address |
2202 N JOHN B DENNIS HWY SUITE 100 |
| City | KINGSPORT |
| State | TN |
| Zip | 37660-5904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shirley J Davis | Nurse Practitioner | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Kingsport, TN 37660-5904 |
| Paige Goforth | Physician Assistant | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Kingsport, TN 37660-5904 |
| Kimberly Nichols | Nurse Practitioner | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Kingsport, TN 37660-5904 |
| Paul Ronald Kramer Jr. | Gynecological Oncology | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Suite 100, Kingsport, TN 37660-5904 |
| Heather C Justice | Physician Assistant | Wellmont Medical Associates Inc | 2202 N John B Dennis Hwy, Kingsport, TN 37660-5904 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lucinda Miller | Critical Care (intensivists) | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Daniel D Carroll | Family Medicine | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Wendy Vogel | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Jennifer Leigh Cox | Nurse Practitioner | Wellmont Medical Associates Inc | 4485 W Stone Dr, Suite 200, Kingsport, TN 37660-1050 |
| Marsha G Rose | Clinical Social Worker | 2005 Venture Park, Kingsport, TN 37660-1098 | |
| Shelley Hilton | Nurse Practitioner | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Hannah Ruth Cook | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Carri Beth Homoky | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Joni Glavan Sago | Dermatology | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Darrell Ray Millsap | Physician Assistant | Dermatology Associates of Kingsport, P.C. | 2300 W Stone Dr, Kingsport, TN 37660-2360 |
| Find all physicians in zip 37660 | |||
| City | KINGSPORT |
| Zip Code | 37660 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | KINGSPORT + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kevin K Blake.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.