MR. GREGORY ALEN BLAKE JR. (NPI# 1780150060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780150060 |
| Entity Type | Individual |
| Full Name | MR. GREGORY ALEN BLAKE JR. |
| Credential | MSN, APRN, FNP-BC |
| Practice Address |
1636 Tunis Dr Harrison OH 45030-2834 |
| Practice Telephone | 5132653449 |
| Mailing Telephone | 5132653449 |
| Enumeration Date | 2018-10-15 |
| Last Update Date | 2018-10-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
APRN.CNP.023765 | OH | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679193684 | Gregory Michael Blake | Pharmacist | 2100 Se Salerno Rd, Stuart, FL 34997-6503 | 2020-04-20 |
| 1073004743 | Gregory Blake | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2018-05-29 |
| 1841257482 | Gregory Harold Blake | Family Medicine | 1924 Alcoa Hwy, U-100, Knoxville, TN 37920-1511 | 2006-04-27 |
| Street Address |
1636 TUNIS DR |
| City | HARRISON |
| State | OH |
| Zip Code | 45030-2834 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225437924 | Emily Hulsmann | Occupational Therapy Assistant | 324 South Elm Street, Harrison, OH 45030 | 2014-08-19 |
| 1265840300 | Kim Hiatt | Home Health Aide | 406 Harrison Ave., Harrison, OH 45030 | 2014-07-31 |
| 1134546369 | Stephanie Marie O'connor | Speech-Language Pathologist | 600 E. Broadway Street, Harrison Elementary, Harrison, OH 45030 | 2014-03-26 |
| 1124442330 | Karen Stephens | Occupational Therapist | 230 S. Elm Str, Harrison, OH 45030 | 2014-02-07 |
| 1497199079 | State Line Treatment Services, LLC | Community/Behavioral Health | 120 May Drive, Harrison, OH 45030 | 2013-04-25 |
| 1881961647 | Kimberly Marie Decarlo | Physical Therapist | 1149 Stone Drive, Suite 500, Harrison, OH 45030 | 2011-11-22 |
| 1154598753 | Bill D. Marinakis | Dentist | 1194 Stone Dr, Harrison, OH 45030 | 2008-05-13 |
| 1508087420 | Rita Maureen Girard | Family Medicine | 10450 New Haven Road, Crossroad Health Center, Harrison, OH 45030 | 2007-05-01 |
| 1285704197 | Alan George Burwinkel | Dermatology | 1149 Stone Dr Ste 100, Harrison, OH 45030 | 2006-11-08 |
| 1265447221 | Drs Ronald Cooke & George Landon Optometrists LLC | Optometrist | 10051 A Simonson Road, Suite 3, Harrison, OH 45030 | 2006-07-29 |
| Find all providers in zip 45030 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760037980 | Juliet Pauletta West | Nurse Practitioner | 106 Calvert Street, Harrison, NY 10528-0001 | 2019-08-05 |
| 1710542410 | Keith Peter Tenhundfeld | Nurse Practitioner | 7995 New Haven Rd, Harrison, OH 45030-9738 | 2019-05-08 |
| 1558820688 | Jennifer Dennette James | Nurse Practitioner | 724 N Spring St Ste A, Harrison, AR 72601-2913 | 2019-03-18 |
| 1013496033 | Sarah Sareang Soeum-skoyles | Nurse Practitioner | 600 Mamaroneck Ave Ste 200, Harrison, NY 10528-1635 | 2018-08-09 |
| 1023543758 | Skipper Dawn Mccormick | Nurse Practitioner | 624 W Central Ave, Harrison, AR 72601-5006 | 2017-05-01 |
| 1306394465 | Rebecca Jane Mcanulty | Nurse Practitioner | 702 N. Springs Street, Harrison, AR 72601 | 2016-09-19 |
| 1811443526 | Asa Dean Smith | Nurse Practitioner | 825 N Main St Ste 1, Harrison, AR 72601-2939 | 2016-09-01 |
| 1336417997 | Susan Lea Zickler | Nurse Practitioner | 103 E Crandall Ave, Harrison, AR 72601-3629 | 2011-12-09 |
| 1366470817 | Connie D Knapper | Nurse Practitioner | 741 Richard Dr, Harrison, MI 48625-9289 | 2006-06-30 |
| 1689622722 | Christie Dawn Wetzel | Nurse Practitioner | 10450 New Haven Rd, Harrison, OH 45030-2780 | 2006-05-04 |
| Find all providers in HARRISON | ||||
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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.