BLAKE MIDDLETON (NPI# 1568703700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568703700 |
| Entity Type | Individual |
| Full Name | BLAKE MIDDLETON |
| Credential | DO |
| Practice Address |
9600 Broadway Ext Oklahoma City OK 73114 |
| Mailing Address |
9600 Broadway Ext Oklahoma City OK 73114-7408 |
| Practice Telephone | (405) 230-9000 |
| Practice Fax Number | 4052309175 |
| Mailing Telephone | 4052309000 |
| Mailing Fax Number | 4052309175 |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2018-06-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
5599 | OK | Allopathic & Osteopathic Physicians |
| N | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Q8566 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3406 S Boulevard, Edmond, OK 730135481 | 4052309700 | 4052309711 |
| Street Address |
9600 BROADWAY EXT |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043218381 | Paul Alan Kammerlocher | Orthopaedic Surgery | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2005-07-11 |
| 1972117190 | Christopher Carlton | Nurse Anesthetist, Certified Registered | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2020-09-04 |
| 1831732155 | Ashley Brooke Edwards | Registered Nurse | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2019-10-18 |
| 1265082945 | Heather Elizabeth Lovett | Physician Assistant | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2019-09-16 |
| 1548816515 | Alexia Mcwaters | Registered Nurse | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2019-08-14 |
| 1215583786 | Matthew Griffin Merrill | Registered Nurse | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2019-08-12 |
| 1326538935 | Leah Coyle | Nurse Anesthetist, Certified Registered | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2018-05-18 |
| 1891296208 | Kimberly Tennille Felix | Registered Nurse | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2018-02-22 |
| 1578082731 | Daniel Shean Smith | Nurse Anesthetist, Certified Registered | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2017-09-19 |
| 1730619545 | Samuel Martinez-morales | Nurse Anesthetist, Certified Registered | 9600 Broadway Ext, Oklahoma City, OK 73114-7408 | 2017-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124669783 | Heather Williams | Occupational Therapist | 1404 Nw122nd St, Oklahoma City, OK 73114 | 2019-10-04 |
| 1477194033 | Shonta Jones | Technician | 10723 Norh Western, Apartment G, Oklahoma City, OK 73114 | 2019-10-04 |
| 1023537644 | Tracye Carter | Registered Nurse | 812 Nw 121 Terr, Oklahom City, OK 73114 | 2017-09-14 |
| 1003362849 | Randy Joshua Williamson | Behavioral Analyst | 101 Bainbridge Rd, Oklahoma City, OK 73114 | 2016-08-31 |
| 1427413368 | John Adrian Howard | Physical Therapist | 13100 N Western Ave Ste 302, Oklahoma City, OK 73114 | 2015-12-18 |
| 1497150197 | Payam Ishani Afousi | Dentist | 9405 N. Penn Place, Casady Square, Oklahoma City, OK 73114 | 2014-10-24 |
| 1922407386 | Kelvin Hughes | Counselor | 1400 Nw 105th Ter, Oklahoma City, OK 73114 | 2014-08-21 |
| 1285056887 | Malarie Jackson | Nurse Practitioner | 609 W. Memorial Rd., Oklahoma City, OK 73114 | 2014-01-16 |
| 1508108705 | Adam Liberty | Community/Behavioral Health | 428 N.w 81st, Oklahoma City, OK 73114 | 2013-03-26 |
| 1780926345 | Michelle D Hardimon | Behavioral Analyst | 700 Ne 122nd Apt 4509, Oklahoma City, OK 73114 | 2013-03-21 |
| Find all providers in zip 73114 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| 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 Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902078298 | Steve Eric Randall | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2008-03-27 |
| 1104219385 | Avenstar Pain Specialists, Pllc | Family Medicine | 5104 S Sooner Rd, Oklahoma City, OK 73135-5440 | 2015-03-11 |
| 1568544062 | Advanced Occupational Rehabilitation, Inc | Family Medicine | 2149 Sw 59th St, Oklahoma City, OK 73119-7033 | 2006-10-20 |
| 1841372349 | Shelly L Venters-jacobs | Family Medicine | 2149 Sw 59th St, Oklahoma City, Oklahoma City, OK 73119-7033 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679936348 | Bryce Rudek | Family Medicine | 591 Pendleton St, Tahlequah, OK 74464-2271 | 2016-03-31 |
| 1619355849 | Leslie Beaty | Family Medicine | 4227 Macys Pl, Moore, OK 73160-2879 | 2015-05-07 |
| 1396044764 | Michelle Rockwell | Family Medicine | 2950 S Elm Pl Ste 120, Broken Arrow, OK 74012-7816 | 2011-03-23 |
| 1407035447 | Steven D. King, D.o., P.c | Family Medicine | 501 E 15th St Ste 400b, Edmond, OK 73013-5040 | 2007-10-26 |
| 1356314603 | Ryan A Pitts | Family Medicine | 301 N Broadway St Ste 301, Poteau, OK 74953-3355 | 2006-02-08 |
| 1518967561 | Steven R Hardage | Family Medicine | 1110 W Will Rogers Blvd, Claremore, OK 74017 | 2005-07-29 |
| 1205836244 | T Jeffrey Emel | Family Medicine | 6475 S Yale Ave Ste 301, Tulsa, OK 74136 | 2005-07-29 |
| 1699311308 | Acellerated Interventional Orthopedics | Family Medicine | 1002 Ne Highway 66 Ste 3, Sayre, OK 73662-9312 | 2019-11-18 |
| 1154845501 | Osumc Professional Services LLC | Family Medicine | 514 Plaza Ct, Sand Springs, OK 74063-7915 | 2017-07-27 |
| 1740694611 | Jenna Lynn Crowder | Family Medicine | 1616 S Kelly Ave, Edmond, OK 73013-3651 | 2014-06-18 |
| Find all providers with the same taxonomy | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73114 |
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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.