DR. BLAKE ISAAC GARDNER (NPI# 1134301997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134301997 |
| Entity Type | Individual |
| Full Name | DR. BLAKE ISAAC GARDNER |
| Credential | MD |
| Practice Address |
1380 E Medical Center Dr Ste 1500 St George UT 84790-2128 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 4352512500 |
| Mailing Telephone | 4352512500 |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2018-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 6803985-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
6803985-1205 | UT | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
6803985-1205 | UT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1380 E Medical Center Dr, Ste 4100, St George, UT 847902123 | 4352512900 | 4352512901 |
| Street Address |
1380 E MEDICAL CENTER DR STE 1500 |
| City | ST GEORGE |
| State | UT |
| Zip Code | 84790-2128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477101574 | Ryan Ross Lamoreaux | Physician Assistant | 1380 E Medical Center Dr Ste 1500, St George, UT 84790-2128 | 2019-09-01 |
| 1033671193 | Skyler Vance Buck | Physician Assistant | 1380 E Medical Center Dr Ste 1500, St George, UT 84790-2128 | 2019-04-05 |
| 1275094369 | Michaela Karrin Johnson | Nurse Practitioner | 1380 E Medical Center Dr Ste 1500, St George, UT 84790-2128 | 2019-03-29 |
| 1891294989 | Kira Salmond | Physician Assistant | 1380 E Medical Center Dr Ste 1500, St George, UT 84790 | 2018-02-05 |
| 1639609357 | Kindra Backman Celani | Nurse Practitioner | 1380 E Medical Center Dr Ste 1500, St George, UT 84790 | 2017-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342713 | Katrina Poulsen | Student in an Organized Health Care Education/Training Program | 617 East Rriverside Dr, Ste 301, St. George, UT 84790 | 2020-10-08 |
| 1124643226 | Desert View Eyecare | Optometrist | 15 South River Road St. 150, St. George, UT 84790 | 2020-06-15 |
| 1366066417 | Benjamin Todd Lloyd | Dentist | 1683 E. Wolf Hole Dr, St. George, UT 84790 | 2020-06-04 |
| 1801434584 | Jennifer M Putnam | Marriage & Family Therapist | 321 North Mall Drive, Vw103, St. George, UT 84790 | 2019-12-12 |
| 1326683012 | Red Mountain Counseling and Education | Counselor | 321 No Mall Dr, Vw 103, St. George, UT 84790 | 2019-11-17 |
| 1295376002 | Karynne Kimberly Simpson | Behavior Technician | 280 N 1680 E U1, St. George, UT 84790 | 2019-10-02 |
| 1962053017 | Mikala Larsen | Nurse Practitioner | 1380 S Medical Center Dr., Saint George, UT 84790 | 2019-09-20 |
| 1326690678 | Joe Ballent | Student in an Organized Health Care Education/Training Program | 1526 S Medical Center Dr Ste 224a, St George, UT 84790 | 2019-07-16 |
| 1558923854 | David Pace | Optometrist | 749 South River Rd, St. George, UT 84790 | 2019-07-08 |
| 1639734924 | Mariah Ann Mertlich | Behavioral Analyst | 280 N 1680 E, U1, St. George, UT 84790 | 2019-05-02 |
| Find all providers in zip 84790 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477698223 | Ihc Health Services Inc | Internal Medicine | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2007-02-20 |
| 1689631913 | Mark William Pulsipher | Internal Medicine | 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 | 2006-04-28 |
| 1164488961 | Alberto Antonio Brizolara | Internal Medicine | 1380 E Medical Center Dr, St George, UT 84790-2123 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700490133 | Advanced Vein and Vascular of Northern Utah LLC | Internal Medicine | 810 S 100 W Ste 120, Logan, UT 84321-5845 | 2020-09-02 |
| 1326679952 | Advanced Vein and Vascular of Southern Utah LLC | Internal Medicine | 1251 Northfield Rd # 103, Cedar City, UT 84721-8622 | 2020-02-02 |
| 1407851488 | Tareq S Harb | Internal Medicine | 4403 Harrison Blvd Ste 3490, Ogden, UT 84403-3284 | 2005-06-16 |
| 1093329427 | Advanced Vein and Vascular of Utah Valley LLC | Internal Medicine | 320 River Park Dr Ste 125, Provo, UT 84604-6065 | 2020-09-02 |
| 1386272755 | Advanced Vein and Vascular of Salt Lake City LLC | Internal Medicine | 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 | 2020-03-31 |
| 1396390316 | American Heart and Vascular Institute PC | Internal Medicine | 5801 S Fashion Blvd Ste 120, Murray, UT 84107-8115 | 2019-08-06 |
| 1114361136 | Lee Anthony Linstroth | Internal Medicine | 30 N 1900 E, Room 4c104, Salt Lake City, UT 84132-0002 | 2013-04-21 |
| 1437446168 | Mountainstar Cardiology St Marks LLC | Internal Medicine | 1160 E 3900 S, Ste. 2000, Salt Lake City, UT 84124-1202 | 2011-07-01 |
| 1417283359 | Canyon Crest Heart & Health L.L.C. | Internal Medicine | 11762 S State St, Draper, UT 84020-7155 | 2009-10-28 |
| 1770720534 | Zubair Cardiovascular Inc | Internal Medicine | 82 South 1100 East, Suite 402, Salt Lake City, UT 84102 | 2009-01-15 |
| Find all providers with the same taxonomy | ||||
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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.