JUDITH BLAKE (NPI# 1942749965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942749965 |
| Entity Type | Individual |
| Full Name | JUDITH BLAKE |
| Credential | PA-C |
| Practice Address |
3610 Springhill Memorial Dr N Mobile AL 36608-1162 |
| Mailing Address |
4517 Southlake Pkwy Hoover AL 35244-3280 |
| Practice Telephone | 2514103600 |
| Mailing Telephone | 2059854111 |
| Mailing Fax Number | 2059854111 |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA.1207 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4517 Southlake Pkwy, Hoover, AL 35244 | 2059854111 | 2059854326 |
| Fot 1060, 1720 2nd Ave S, Birmingham, AL 352943410 | 2059966536 |
| Street Address |
3610 SPRINGHILL MEMORIAL DR N |
| City | MOBILE |
| State | AL |
| Zip Code | 36608-1162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740288679 | Gulf Coast Surgical Partners LLC | Clinic/Center | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2005-07-13 |
| 1467053645 | Sara M Beck | Occupational Therapist | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2020-11-04 |
| 1518591569 | Alabama Joint Replacement, LLC | Case Management | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2020-02-28 |
| 1851923064 | Heather Pope Setterstrom | Nurse Practitioner | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2020-02-05 |
| 1558830885 | Chrysthian Ivan Uribe Avalos | Physical Therapist | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2018-11-15 |
| 1972010056 | Samantha Catlett Wooten | Nurse Practitioner | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2018-01-10 |
| 1225549215 | Taylor Lewis | Occupational Therapist | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2017-10-17 |
| 1659898302 | Savannah Sterling Shumake | Physical Therapist | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2017-08-24 |
| 1184140758 | Andrea Leigh Brantley | Nurse Practitioner | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2017-08-16 |
| 1447794862 | Sarah Goode | Nurse Practitioner | 3610 Springhill Memorial Dr N, Mobile, AL 36608-1162 | 2016-12-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475524 | Grantham Dental, Inc. | Dentist | 3620 Springhill Memorial Drive South, Mobile, AL 36608 | 2020-10-21 |
| 1114540879 | Dearrius Hines | Home Health Aide | 1370 Lucerne Dr, Mobile, AL 36608 | 2020-05-28 |
| 1558980409 | Rachel Stevens | Registered Nurse | 8507 Tanner Williams Rd, Mobile, AL 36608 | 2020-04-10 |
| 1073170700 | Usa Health Physician Billing Services LLC | Otolaryngology | 5721 Usa Drive North, Hahn 1119, Mobile, AL 36608 | 2019-05-29 |
| 1952885600 | Franklin Primary Health Center Inc. | Dentist | 990 Cody Rd North, Mobile, AL 36608 | 2018-09-19 |
| 1114410040 | Zackary Elkins | Optometrist | 105 W I65 Service Rd N, Mobile, AL 36608 | 2018-06-14 |
| 1023562865 | Covenant Hospice, Inc. | Internal Medicine | 6801 Airport Blvd., Main Tower, 11th Floor North, Mobile, AL 36608 | 2016-08-10 |
| 1730575416 | Rayven Likely | Student in an Organized Health Care Education/Training Program | 1014 Centerwood Dr, Mobile, AL 36608 | 2015-04-09 |
| 1598040461 | Robert S Harlin | Specialist | 75 Clarise Circle, Mobile, AL 36608 | 2011-10-11 |
| 1972884948 | Heidi Michelle Mcdermott | Physical Therapist | 5721 Usa Drive N, Hahn 2050, Mobile, AL 36608 | 2011-09-06 |
| Find all providers in zip 36608 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437308665 | Melanie D. Busby | Physician Assistant | 3610 Springhill Memorial Dr. N., Mobile, AL 36608-1162 | 2008-09-11 |
| 1558396093 | Karen Renae Jordan | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2006-07-12 |
| 1346756160 | Nicholas K Bolling | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608-3143 | 2017-12-15 |
| 1104345263 | Nathanael Christopher Stuck | Physician Assistant | 1601 Center St Ste 2s, Mobile, AL 36604-1541 | 2017-09-10 |
| 1740654631 | Brent Wildberger | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2015-11-16 |
| 1508269283 | Cassie Jones | Physician Assistant | 1855 Spring Hill Ave, Mobile, AL 36607-2301 | 2014-10-08 |
| 1972931533 | Shawn Clark, M.d., P.C. | Physician Assistant | 6701 Airport Blvd, #c138, Mobile, AL 36608-6705 | 2013-10-17 |
| 1841524212 | Claire Hinton Naylor | Physician Assistant | 6144 Airport Blvd, Mobile, AL 36608 | 2009-10-01 |
| 1396994521 | Susan Angerholzer Overton | Physician Assistant | 1901 Springhill Ave, Mobile, AL 36607-2303 | 2008-09-11 |
| 1649328097 | Christine Paragone | Physician Assistant | 1901 Springhill Ave, Mobile, AL 36607-2303 | 2007-01-08 |
| Find all providers in MOBILE | ||||
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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.