JENNIFER MARIE BLAKE (NPI# 1891952370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891952370 |
| Entity Type | Individual |
| Full Name | JENNIFER MARIE BLAKE |
| Credential | MD |
| Practice Address |
3901 Beaubien St Childrens Hospital of Mi 4th Fl Detroit MI 48201-2119 |
| Mailing Address |
4201 Saint Antoine St Uhc 5d - Mailbox 226 University Pediatricians Detroit MI 48201-2153 |
| Practice Telephone | 3137455484 |
| Practice Fax Number | 3139662423 |
| Mailing Telephone | 3137454405 |
| Mailing Fax Number | 3139660665 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2017-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
4301090782 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629623574 | Jennifer Ann Blake | Social Worker | 5000 S 5th Ave Bldg 200, Hines, IL 60141-3030 | 2019-08-07 |
| 1508198078 | Jennifer Lynn Blake | Speech-Language Pathologist | 3161 Sw 50th St, Ft. Lauderdale, FL 33312 | 2010-02-08 |
| 1972620110 | Jennifer Kay Blake | Counselor | 150 Shelton Mcmurphey Blvd Ste 101, Eugene, OR 97401-5015 | 2007-03-23 |
| 1114552585 | Jennifer E Blake | Social Worker | 2900 W Prospect Rd, Fort Lauderdale, FL 33309-2519 | 2020-03-06 |
| 1497245708 | Jennifer Christina Blake | Student in an Organized Health Care Education/Training Program | 6410 Fannin St Ste 1400, Houston, TX 77030-5389 | 2018-05-11 |
| 1023535739 | Jennifer K Blake | Physical Therapist | 594 Broadway, New York, NY 10012-3233 | 2017-08-23 |
| 1942641550 | Jennifer Blake | Occupational Therapist | 2501 Downing St Sw, Wilson, NC 27893-4517 | 2013-07-11 |
| 1457649204 | Jennifer L Blake | Counselor | 11630 Se 40th Ave, Suite A, Milwaukie, OR 97222-6195 | 2011-07-14 |
| 1982998282 | Jennifer Lynn Blake | Physical Therapist | 506 Plain St, Suite 101, Marshfield, MA 02050-2744 | 2011-06-03 |
| 1598073835 | Jennifer Marie Blake | Registered Nurse | 601 E 15th St, Austin, TX 78701-1930 | 2010-09-21 |
| Street Address |
3901 BEAUBIEN ST CHILDRENS HOSPITAL OF MI 4TH FL |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679511737 | Richard A. Humes | Pediatrics | 3901 Beaubien Blvd -, Childrens Hospital of Michigan 4th Fl, Detroit, MI 48201 | 2006-06-02 |
| 1174560668 | Peter P. Karpawich | Pediatrics | 3901 Beaubien - 4th Fl, Childrens Hospital of Michigan, Detroit, MI 48201 | 2006-06-01 |
| 1831485382 | Stuart Covi | Pediatrics | 22201 Moross Rd, Suite 275, Detroit, MI 48236-2169 | 2011-06-23 |
| 1942488945 | David K. Lawrence | Pediatrics | 3901 Beaubien, 4th Fl, Detroit, MI 48201 | 2008-02-01 |
| 1861615007 | Pooja Gupta | Pediatrics | 3901 Beaubien - 4th Fl, Childrens Hospital of Mi, Detroit, MI 48201-2119 | 2007-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801453287 | Pediatric Cardiology of Southeastren Michigan | Pediatrics | 1934 Bluff Ct, Troy, MI 48098-6616 | 2019-05-21 |
| 1417222779 | Sujatha Buddhe | Pediatrics | 2289 Dorchester Dr N Apt 203, Troy, MI 48084-3723 | 2012-03-19 |
| 1316244304 | Rossitza Prokopieva Pironkova | Pediatrics | 43380 Woodward Ave Ste 105, Bloomfield Hills, MI 48302-5050 | 2011-02-28 |
| 1881709871 | Hani Zreik | Pediatrics | 900 Cooper Avenue, Suite 4200, Saginaw, MI 48602-5394 | 2006-08-20 |
| 1326080102 | James Lee Christiansen | Pediatrics | 1414 West Fair Ave, Ste 334, Marquette, MI 49855 | 2006-06-13 |
| 1700826542 | James L Christiansen Md PC | Pediatrics | 1414 West Fair Avenue, Suite 334, Marquette, MI 49855 | 2006-06-08 |
| 1013977115 | Elliott Weinhouse | Pediatrics | 3535 W 13 Mile Rd Ste 108, Royal Oak, MI 48073-6770 | 2006-03-24 |
| 1770551301 | Hanna Michel Khouri | Pediatrics | 43380 Woodward Ave, Ste 105, Bloomfield Hills, MI 48302 | 2006-03-09 |
| 1013903947 | Linda Barbara Pauliks | Pediatrics | 25 Michigan St Ne Ste 4200, Grand Rapids, MI 49503-2559 | 2005-09-26 |
| 1083608806 | Anuradha Prabhu | Pediatrics | 44199 Dequindre Rd Ste 615, Beaumont Pediatric Subspecialty Clinic, Troy, MI 48085-1128 | 2005-09-08 |
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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.