BLAKE RUSSELL HENDERSON (NPI# 1295342848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295342848 |
| Entity Type | Individual |
| Full Name | BLAKE RUSSELL HENDERSON |
| Practice Address |
515 W 75th St Kansas City MO 64114-1512 |
| Mailing Address |
4407 Ne 45th Ter Kansas City MO 64117-1823 |
| Practice Telephone | 8167456270 |
| Mailing Telephone | 8167456270 |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-09-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MO | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689178584 | Blake Henderson | Behavioral Analyst | 3230 E Imperial Hwy Ste 203, Brea, CA 92821-1706 | 2018-03-23 |
| 1992064893 | Blake Tarleton Henderson | Student in an Organized Health Care Education/Training Program | 2425 Geary Blvd # M160, San Francisco, CA 94115-3358 | 2012-05-11 |
| Street Address |
515 W 75TH ST |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64114-1512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164055968 | Nova Home Infusion, LLC | Home Infusion | 7611 State Line Road, Suite 130 B, Kansas City, MO 64114 | 2020-02-20 |
| 1770011017 | Rene Thomsen | Counselor | 222 W Gregory Blvd Ste 120, Kansas City, MO 64114 | 2017-05-31 |
| 1114452075 | Accent Home Health Care LLC | In Home Supportive Care | 7817 Wornall Rd, Kansas City, MO 64114 | 2017-04-27 |
| 1174982599 | Mei Dodson | Contractor | 8901 Washington St, Kansas City, MO 64114 | 2016-02-12 |
| 1851784805 | Sarah Jeannette Gulledge | Registered Nurse | 930 Carondelet Dr., Suite 201, Kansas City, MO 64114 | 2015-03-16 |
| 1376936591 | Corey Bess | Podiatrist | 1010 Carondelet Dr Ste 301, Kansas City, MO 64114 | 2015-03-12 |
| 1013339753 | Kati Mayer | Physical Therapist | 10008 Walnut Dr., #202, Kansas City, MO 64114 | 2014-01-15 |
| 1619270311 | Gavett Burch | Marriage & Family Therapist | 222 W Gregory Blvd., Suite #319, Kansas City, MO 64114 | 2010-12-18 |
| 1679873046 | Ken Kidd Inc Dba Miracle-ear | Hearing Instrument Specialist | 1148 W. 103rd St, Kansas City, MO 64114 | 2010-11-01 |
| 1316264161 | Elizabeth Vasquez | Physician Assistant | 1004 Carondelet Dr., Suite 330, Kansas City, MO 64114 | 2010-05-03 |
| Find all providers in zip 64114 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043819642 | Ashley Chanele Ball | Massage Therapist | 959 W 42nd St Apt 201, Kansas City, MO 64111-4058 | 2020-10-23 |
| 1619576303 | Robert Wayne Fuller Jr. | Massage Therapist | 7211 Nw 83rd St Ste 207d, Kansas City, MO 64152-6022 | 2020-10-22 |
| 1982201471 | Kendra Wright | Massage Therapist | 115 W 99th Ter Apt 206, Kansas City, MO 64114-4330 | 2020-10-07 |
| 1073120622 | Britnee N Merritt | Massage Therapist | 6715 Walrond Ave, Kansas City, MO 64132-3047 | 2020-09-28 |
| 1871100446 | Simeon Marie Neely | Massage Therapist | 4010 Washington St Ste 205, Kansas City, MO 64111-2625 | 2020-09-28 |
| 1275146805 | Rachel E Fracassa | Massage Therapist | 8125 E Gregory Blvd, Kansas City, MO 64133-6243 | 2020-08-24 |
| 1215561121 | Healing Hands Massage Dba Total Bliss Massage & Float Therapy | Massage Therapist | 9770 N Ash Ave, Kansas City, MO 64157-9742 | 2020-02-29 |
| 1679118087 | Kendra Jeanne Grimes | Massage Therapist | 7000 Nw Prairie View Rd Ste 130, Kansas City, MO 64151-3808 | 2019-11-08 |
| 1952944555 | Jevae Chrishaun Collins | Massage Therapist | 12013 E 47th St, Kansas City, MO 64133-2517 | 2019-10-26 |
| 1386101681 | Tynesia Davis | Massage Therapist | 8250 N Booth Ave, Kansas City, MO 64158-7201 | 2019-02-23 |
| Find all providers in KANSAS CITY | ||||
| City | KANSAS CITY |
| Zip Code | 64114 |
Please comment or provide details below to improve the information on BLAKE RUSSELL HENDERSON.
| 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.