LLOYD W. BLAKE (NPI# 1487730735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487730735 |
| Entity Type | Individual |
| Full Name | LLOYD W. BLAKE |
| Credential | MD |
| Practice Address |
2347 E Gala St Meridian ID 83642-4881 |
| Mailing Address |
190 E Bannock St Boise ID 83712-6241 |
| Practice Telephone | 2083233767 |
| Mailing Telephone | 2083812222 |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2017-04-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
M11127 | ID | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
M11127 | ID | Allopathic & Osteopathic Physicians |
| N | 207RS0012X |
Internal Medicine Specialization: Sleep Medicine |
M11127 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | RR MEDICARE | P00137593 | 01 |
| ND | 13251 | 05 |
| Street Address |
2347 E GALA ST |
| City | MERIDIAN |
| State | ID |
| Zip Code | 83642-4881 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588649412 | Thomas E O'mara | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2005-12-14 |
| 1780032649 | Brent Taylor | Physician Assistant | 2347 E Gala St, Meridian, ID 83642-4881 | 2016-06-01 |
| 1215396478 | Jennifer Ann Fulton Hofer | Nurse Practitioner | 2347 E Gala St, Meridian, ID 83642-4881 | 2016-02-16 |
| 1407214497 | Amy Dancer | Registered Nurse | 2347 E Gala St, Meridian, ID 83642-4881 | 2016-02-04 |
| 1922363720 | Danielle V Brunk | Nurse Practitioner | 2347 E Gala St, Meridian, ID 83642-4881 | 2012-07-08 |
| 1962773655 | Molly K. Lynn | Nurse Practitioner | 2347 E Gala St, Ste 150, Meridian, ID 83642-4881 | 2012-01-26 |
| 1003110313 | Eric Ld Scholten | Internal Medicine | 2347 E Gala St, Meridian, ID 83642 | 2010-12-29 |
| 1477874360 | Andrew David Reger | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2010-06-15 |
| 1205034238 | David E Fonseca | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-07-11 |
| 1053521203 | Oleg Sergeevich Kouskov | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174145684 | Ikdo South Meridian LLC | Dentist | 3839 E Amity Rd, Meridian, ID 83642 | 2020-05-07 |
| 1073133328 | Prescription Pad LLC | Pharmacy | 885 S Vanguard Way, Meridian, ID 83642 | 2020-04-16 |
| 1609412683 | Meridian Advanced Psychiatry, LLC | Psychiatry & Neurology | 1672 S Woodsage Ave., Meridan, ID 83642 | 2019-11-25 |
| 1194378927 | Sergey Tsema | Occupational Therapist | 1259 E Pisa St, Meridian, ID 83642 | 2019-07-21 |
| 1003478629 | Chris R Jackson | Dentist | Isu Family Dentistry, 1311 E Central Dr, Meridian, ID 83642 | 2019-07-03 |
| 1285293118 | Morgan Family Medicine | Nurse Practitioner | 1660 S Woodsage Avenue, Meridian, ID 83642 | 2019-06-13 |
| 1033772793 | Nugen Healthcare, Pllc | Registered Nurse | 2177 S Spoonbill Ave, Meridian, ID 83642 | 2019-04-18 |
| 1811471790 | Courtney Crossland | Physician Assistant | 4949 S Hillsdale Ave., Meridian, ID 83642 | 2018-09-18 |
| 1841771938 | Katelyn Perry | Counselor | 2068 S. Eagle Rd., Meridian, ID 83642 | 2018-08-27 |
| 1114406204 | Gem Prep: Meridian LLC | Case Management | 2750 E.gala Ct., Meridian, ID 83642 | 2018-08-09 |
| Find all providers in zip 83642 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033461009 | Juantina Johnson Md LLC | Internal Medicine | 1314 19th Ave, Meridian, MS 39301-4116 | 2012-10-15 |
| 1629117619 | Karen S Miller | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-06 |
| 1659419448 | James P Souza | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-02 |
| 1730227927 | William G Bergquist | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1104964204 | Wendi M Norris | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1790823904 | Saadia R Akhtar | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1154469328 | William J Dittrich | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1467590661 | David E Sasso | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1265570360 | Sogol Nowbar | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2007-02-01 |
| 1578591210 | Brian W Goltry | Internal Medicine | 2347 E Gala St, Meridian, ID 83642-4881 | 2006-06-29 |
| Find all providers in MERIDIAN | ||||
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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.