BLAKE T GREENFIELD (NPI# 1578501326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578501326 |
| Entity Type | Individual |
| Full Name | BLAKE T GREENFIELD |
| Credential | PA-C |
| Practice Address |
2900 Doolittle Dr Ellsworth Afb SD 57706 |
| Mailing Address |
2900 Doolittle Dr Ellsworth Afb SD 57706-4821 |
| Practice Telephone | 6053853111 |
| Mailing Telephone | 6053853208 |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-05-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0553 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | NCCPA CERT | 1058388 | 01 |
| SD | LICENSE PHYSICIAN ASSISTANT | 0553 | 01 |
| Street Address |
2900 DOOLITTLE DR |
| City | ELLSWORTH AFB |
| State | SD |
| Zip Code | 57706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083607535 | Michael Scott Bogaard | Optometrist | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2005-08-30 |
| 1023648128 | Sereirath Som Hart | Social Worker | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2020-01-17 |
| 1811459662 | Anthony David Delcorral | Dentist | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2019-04-02 |
| 1942766746 | Joseph Minette Stanfill | Social Worker | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2019-02-16 |
| 1275016214 | Elizabeth Gunnell | Counselor | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2018-09-14 |
| 1760989933 | Jeffrey Moran | Pharmacist | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2018-04-12 |
| 1851898191 | Stephen Beals | Pharmacist | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2018-04-12 |
| 1205330651 | Ariel Hough | Dentist | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2018-03-21 |
| 1629576491 | Mario Luis Recupido IIi | Military Health Care Provider | 2900 Doolittle Dr, Ellsworth Afb, SD 57706 | 2018-01-26 |
| 1205342664 | Sheila Renee Johnson | Social Worker | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2017-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801307202 | Patrick David Jones | Physician Assistant | 28th Mdg/sggp, 2900 Doolittle Dr., Ellsworth Afb, SD 57706 | 2017-10-12 |
| 1770736522 | Amy Marie Kubal | Dietitian, Registered | 2450 Risner Drive, Ellsworth Air Force Base Health and Wellness Center, Ellsworth Afb, SD 57706 | 2008-10-24 |
| 1275057754 | Adrianne Rae Littles | Military Health Care Provider | 2900 Doolittle Drive, Ellsworth Afb, SD 57706 | 2017-07-27 |
| 1467501874 | Tasha Dee Standing Soldier | Pharmacist | 2900 Doolittle Drive, 28th Medical Group, Ellsworth Afb, SD 57706 | 2007-01-09 |
| 1326286899 | Michelle Andaya Ziegler | Physical Therapist | 532 Tallent Ct, Ellsworth Afb, SD 57706-1717 | 2009-01-21 |
| 1528330081 | Marryanne Allen | Nurse Practitioner | 105 Red Cloud Ct, Ellsworth Afb, SD 57706-1724 | 2012-01-30 |
| 1710201553 | Ivan Vicente | Military Health Care Provider | 433 Black Elk Ct, Ellsworth Afb, SD 57706-1847 | 2010-03-23 |
| 1831539642 | Brendan Robert Cleary | Pediatrics | 28th Medical Group, Ellsworth Afb, 6000 Doolittle Drive, Rapid City, SD 57706-1873 | 2013-06-26 |
| 1922094671 | Scott Anthony Jones | Physical Therapist | 2450 Risner Dr, Ellsworth Afb, SD 57706-4704 | 2005-09-27 |
| 1174703144 | Michelle Renaee Haleck | Dietitian, Registered | 2450 Risner Dr, Ellsworth Air Force Base, Ellsworth Afb, SD 57706-4704 | 2007-11-07 |
| Find all providers in zip 57706 | ||||
| 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 |
|---|---|---|---|---|
| 1801307202 | Patrick David Jones | Physician Assistant | 28th Mdg/sggp, 2900 Doolittle Dr., Ellsworth Afb, SD 57706 | 2017-10-12 |
| 1104337450 | Michael J Vadovsky | Physician Assistant | 2900 Doolittle Dr, Ellsworth Afb, SD 57706 | 2017-10-13 |
| 1801211123 | Jordan Hickman | Physician Assistant | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2014-02-24 |
| 1407868854 | Audrey Mcreavy | Physician Assistant | 2900 Doolittle Dr, Ellsworth Afb, SD 57706-4821 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627898 | Mikaela Theobald | Physician Assistant | 6101 E Quartzite Dr, Sioux Falls, SD 57110-3988 | 2020-10-22 |
| 1497368153 | Emily Christine Fedders | Physician Assistant | 512 Broadway St, Centerville, SD 57014-2225 | 2020-08-24 |
| 1467064097 | Kara Rae Koth | Physician Assistant | 4913 E 42nd St, Sioux Falls, SD 57110-4409 | 2020-08-17 |
| 1104448851 | Alexandra L Bachman-williams | Physician Assistant | 24337 Us Highway 212, Eagle Butte, SD 57625-7770 | 2020-05-15 |
| 1528695798 | Allison Mcentee | Physician Assistant | 3620 East Prairiewind Street, Sioux Falls, SD 57108 | 2020-03-26 |
| 1114551447 | Eugenie Coleman | Physician Assistant | 2510 Arrow St, Rapid City, SD 57702-4306 | 2020-02-25 |
| 1235780883 | Alyssa Jo Bump | Physician Assistant | 202 Island Dr Ste 1, Fort Pierre, SD 57532-7303 | 2019-09-25 |
| 1326608910 | Ashley Pommer | Physician Assistant | 8232 W 51st St, Sioux Falls, SD 57106-7861 | 2019-06-17 |
| 1316465925 | Timothy Brian Olsen | Physician Assistant | 621 Ridge Road, Lead, SD 57754 | 2017-09-03 |
| 1225550908 | Almir Krdzalic | Physician Assistant | 110 W Honors St, Sioux Falls, SD 57108-8174 | 2017-07-13 |
| Find all providers with the same taxonomy | ||||
| City | ELLSWORTH AFB |
| Zip Code | 57706 |
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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.