ELIJAH BLAIR (NPI# 1336663863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336663863 |
| Entity Type | Individual |
| Full Name | ELIJAH BLAIR |
| Credential | MPAS, PA-C |
| Practice Address |
3501 Cranberry Blvd Weston WI 54476-5213 |
| Mailing Address |
N3043 Mink Dr Medford WI 54451-9128 |
| Practice Telephone | 7153931000 |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2017-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 4114-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3501 CRANBERRY BLVD |
| City | WESTON |
| State | WI |
| Zip Code | 54476-5213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972500718 | William J Moran | Otolaryngology | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2005-07-07 |
| 1356956015 | Stacey Lee Meyer | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2020-09-10 |
| 1992336655 | Mchs Hospitals, Inc. | Clinic/Center | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2020-01-31 |
| 1548804511 | Alyssa Anne Hovda | Dietitian, Registered | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2019-11-03 |
| 1144875824 | Rebecca Ann Kollross | Physician Assistant | 3501 Cranberry Blvd, Weston, WI 54476 | 2019-08-08 |
| 1891266060 | Laura Lauer | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-12-16 |
| 1356816201 | Khamal Misra | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-10-08 |
| 1164915971 | Crystal Farrand | Physician Assistant | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2018-06-07 |
| 1275915597 | Kari Mizgalski | Dietitian, Registered | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2015-06-23 |
| 1235569237 | Jenell Bushong | Nurse Practitioner | 3501 Cranberry Blvd, Weston, WI 54476-5213 | 2013-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406309 | Kelly Hodge | Technician | 118 Marguerite St, Schofield, WI 54476 | 2019-09-13 |
| 1427557529 | Brandon David Parmer | Licensed Practical Nurse | 134 Kurth St, Schofield, WI 54476 | 2018-02-05 |
| 1558880583 | Kellie Cares Medical, LLC | Non-emergency Medical Transport (VAN) | 4311 Schofield Ave, #97, Weston, WI 54476 | 2017-09-11 |
| 1679018022 | Alexis Legenza | Behavioral Analyst | 4601 Camp Phillips Rd, Weston, WI 54476 | 2016-12-21 |
| 1699176487 | Reenu Mathew | Pharmacist | 5305 U.S. Hwy Business 51, Weston, WI 54476 | 2014-09-11 |
| 1063812246 | Brian Weiland | Psychologist | 2405 Schofield Ave Ste 220, Weston, WI 54476 | 2014-08-25 |
| 1194087759 | Susan C Coady | Physical Therapist | 4605 Valres Springs Court, Weston, WI 54476 | 2012-06-11 |
| 1053437467 | Emmie Jo Kasat | Speech-Language Pathologist | 4605 Valdres Springs Court, Weston, WI 54476 | 2007-03-21 |
| 1326181322 | Lisa Marie Skutak | Dentist | 700 Eagle Nest Boulevard, Suite E, Rothschild, WI 54476 | 2007-02-15 |
| 1205976776 | Quirt Family Dentistry Sc | Dentist | 3417 Schofield Avenue, Schofield, WI 54476 | 2007-02-07 |
| Find all providers in zip 54476 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932713047 | Pedro G Bolanos Sr. | Physician Assistant | 460 Alexandra Cir, Weston, FL 33326-3308 | 2020-09-04 |
| 1437775111 | Kelsey Nicole Kunes | Physician Assistant | 15 Bakers Hill Rd, Weston, MA 02493-1708 | 2020-06-18 |
| 1831615178 | Laura Villafane | Physician Assistant | 2625 Executive Park Dr Ste 7, Weston, FL 33331-3634 | 2017-08-18 |
| 1831636349 | Eva Frances Santos | Physician Assistant | 1321 St Tropez Cir, Apt 1003, Weston, FL 33326-3014 | 2017-01-22 |
| 1790236560 | Maria Jimena Ortiz | Physician Assistant | 1319 Camellia Cir, Weston, FL 33326-3615 | 2016-10-17 |
| 1619427903 | Nicole Triana | Physician Assistant | 2500 Weston Rd Ste 103, Weston, FL 33331-3616 | 2016-10-11 |
| 1902292022 | Alexandra Elios | Physician Assistant | 2625 Executive Drive, Suite 7, Weston, FL 33331-3634 | 2015-04-15 |
| 1184022345 | Noya Kantor | Physician Assistant | 2625 Executive Park Drive, Suite 7, Weston, FL 33331-3634 | 2014-12-19 |
| 1467562843 | Deborah Mendoza | Physician Assistant | 2300 N Commerce Pkwy Ste 303, Weston, FL 33326-3256 | 2006-08-30 |
| 1326054289 | Melinda Joyce Orrahood | Physician Assistant | 936 Sharpe Hospital Road, William R Sharpe Jr Hospital, Weston, WV 26452 | 2006-07-31 |
| Find all providers in WESTON | ||||
Please comment or provide details below to improve the information on ELIJAH BLAIR.
| 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.