DR. MICHAEL G BLAKE (NPI# 1831161264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831161264 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL G BLAKE |
| Credential | O.D. |
| Practice Address |
124 W Coal Ave Gallup NM 87301-6206 |
| Practice Telephone | 5057222020 |
| Practice Fax Number | 5058632204 |
| Mailing Telephone | 5057222020 |
| Mailing Fax Number | 5058632204 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2008-12-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2241 | NM | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2241 | NM | Eye and Vision Services Providers |
| N | 152WL0500X |
Optometrist Specialization: Low Vision Rehabilitation |
2241 | NM | Eye and Vision Services Providers |
| N | 152WS0006X |
Optometrist Specialization: Sports Vision |
2241 | NM | Eye and Vision Services Providers |
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
2241 | NM | Eye and Vision Services Providers |
| N | 152WX0102X |
Optometrist Specialization: Occupational Vision |
2241 | NM | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | BLUE CROSS BLUE SHIELD NM | NM00O520 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154894434 | Michael Blake | Dietitian, Registered | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2019-01-09 |
| 1861876963 | Michael Blake | Psychologist | 25 Main St., Office 322, Stockbridge, MA 01262-0962 | 2015-07-17 |
| 1013217231 | Michael Blake | Counselor | 201 W Springdale Ave, Knoxville, TN 37917-5158 | 2010-10-22 |
| 1417111493 | Michael Laurence Blake | Internal Medicine | 600 River Ave, Lakewood, NJ 08701-5237 | 2008-07-18 |
| 1225205230 | Michael Scott Blake | Emergency Medicine | 300 Main St, Lewiston, ME 04240-7027 | 2008-05-09 |
| 1588855803 | Michael Todd Blake | Emergency Medicine | 250 Hospital Place, Central Peninsula Hospital, Soldotna, AK 99669 | 2007-08-05 |
| 1457394736 | Michael C. Blake | Emergency Medicine | 2018 W Clinch Ave, Knoxville, TN 37916-2301 | 2006-06-14 |
| 1578513701 | Michael Joseph Blake | Pediatrics | 206 Alaska Frontage Rd, Belgrade, MT 59714-7909 | 2006-05-10 |
| 1063474955 | Michael Clarence Blake | Surgery | 2790 Godwin Blvd, Ste 305, Suffolk, VA 23434-8151 | 2006-04-05 |
| 1265411896 | Michael John Blake | Anesthesiology | 6001 E Broad St, Columbus, OH 43213-1502 | 2006-01-12 |
| Street Address |
124 W COAL AVE |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-6206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912142241 | Michael G Blake and Associates Inc. | Optometrist | 124 W Coal Ave, Gallup, NM 87301-6206 | 2008-12-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558599217 | Matthew David Mcgraw | Optometrist | 816 Boardman Dr, Gallup, NM 87301-4711 | 2009-07-01 |
| 1598889891 | Quint Di Giacomo | Optometrist | 112 W Hill Ave, Gallup, NM 87301-6218 | 2007-03-19 |
| 1063559961 | Eye Associates of New Mexico Ltd | Optometrist | 311 Nizhoni Blvd, Gallup, NM 87301 | 2007-01-31 |
| 1083770119 | Walter Ernest Balfour | Optometrist | 219 W Coal Ave, Gallup, NM 87301-6305 | 2007-01-01 |
| 1003999301 | Farid Elie Khoury | Optometrist | 1500 S 2nd St Ste 5, Gallup, NM 87301-5898 | 2006-10-23 |
| 1700994944 | Robert L Dorazio | Optometrist | 225 Nizhoni Blvd, Gallup, NM 87301 | 2006-08-28 |
| 1689670861 | Michael Davis | Optometrist | 516 Nizhoni Blvd, Department 18, Gallup, NM 87301-5748 | 2005-06-22 |
| 1740804798 | Lilian Thoi | Optometrist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-06-05 |
| 1447873070 | Laila Brown-aijala | Optometrist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-05-18 |
| 1417583915 | Justin Crockett | Optometrist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-03-16 |
| Find all providers in GALLUP | ||||
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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.