SAL BLAKE (NPI# 1962981084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962981084 |
| Entity Type | Individual |
| Full Name | SAL BLAKE |
| Credential | PA-C |
| Practice Address |
2211 Mayfair Dr Ste 102 Owensboro KY 42301 |
| Mailing Address |
Po Box 23229 Owensboro KY 42304-3229 |
| Practice Telephone | 2706881351 |
| Practice Fax Number | 2706833420 |
| Mailing Telephone | 2706881330 |
| Mailing Fax Number | 2706881338 |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2019-05-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | TC733 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100552610 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2801 Unifirst Dr, Owensboro, KY 423017701 | 2707130478 | 2707130479 |
| Street Address |
2211 MAYFAIR DR STE 102 |
| City | OWENSBORO |
| State | KY |
| Zip Code | 42301 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215172721 | Kirsten M Ahnell | Physician Assistant | 2211 Mayfair Dr Ste 102, Owensboro, KY 42301-4569 | 2008-12-12 |
| 1912264284 | Cletus Kobiah Oppong | Preventive Medicine | 2211 Mayfair Dr Ste 102, Owensboro, KY 42301-4569 | 2012-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124558002 | To The Max Behavior Therapy, LLC | Behavioral Analyst | 905 Griffith Avenue, Owensboro, KY 42301 | 2017-06-14 |
| 1558747014 | Kendall L Tapp | Counselor | 1925 Frederica St, Owensboro, KY 42301 | 2015-08-07 |
| 1104168210 | Behavior Associates, LLC | Psychologist | 3445 Wathens Xing Ste 104, Owensboro, KY 42301 | 2013-03-27 |
| 1285990259 | Jaime E Ford | Preventive Medicine | 1723 Windsor Ave., Owensboro, KY 42301 | 2012-04-04 |
| 1457637043 | Bliss United Dental Services Dba Owensboro Family Dentistry | Dentist | 4921 Goetz Dr., Owensboro, KY 42301 | 2011-10-26 |
| 1932483138 | Dennis Craig Hodges | Pharmacist | 2318 Frederica Street, Owensboro, KY 42301 | 2011-10-06 |
| 1225317381 | Donna Kay Ewing | Social Worker | 1925 Frederica St Ste 200, Owensboro, KY 42301 | 2011-08-08 |
| 1639489230 | Easycare Inc | Durable Medical Equipment & Medical Supplies | 5010 Back Square Drive, Owensboro, KY 42301 | 2010-10-15 |
| 1962727529 | Amy Martin | Physical Therapy Assistant | 2420 West Thrid Street, Owensboro, KY 42301 | 2010-04-07 |
| 1215163837 | Green River District Health Department | Public Health or Welfare | 5390 Hwy 56, Owensboro, KY 42301 | 2009-06-10 |
| Find all providers in zip 42301 | ||||
| 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 |
|---|---|---|---|---|
| 1992292288 | Owensboro Health Medical Group Inc | Physician Assistant | 2235 Mayfair Dr, Owensboro, KY 42301-4519 | 2018-04-23 |
| 1134649783 | Jeffrey Brown | Physician Assistant | 2200 E Parrish Ave Ste 100, Owensboro, KY 42303-1449 | 2017-06-25 |
| 1215172721 | Kirsten M Ahnell | Physician Assistant | 2211 Mayfair Dr Ste 102, Owensboro, KY 42301-4569 | 2008-12-12 |
| 1831124908 | Julie Salisbury | Physician Assistant | 2609 New Hartford Rd Ste 1, Owensboro, KY 42303-1316 | 2006-07-11 |
| 1497754279 | Amanda D. Murphy | Physician Assistant | 1102 Triplett St, Ste. 1000, Owensboro, KY 42303-3104 | 2005-07-14 |
| 1386261089 | Trevor Warfield | Physician Assistant | 2821 New Hartford Rd, Owensboro, KY 42303-1320 | 2020-06-29 |
| 1841822327 | Deaconess Hospital Inc | Physician Assistant | 2609 New Hartford Rd, Owensboro, KY 42303-1316 | 2020-02-12 |
| 1811535248 | Jacquelyn N Lohmann | Physician Assistant | 1301 Pleasant Valley Rd Ste 404, Owensboro, KY 42303-9774 | 2019-12-17 |
| 1114569670 | Nicholas Lee Morris | Physician Assistant | 1201 Pleasant Valley Rd, Owensboro, KY 42303-9811 | 2019-10-16 |
| 1437707478 | Ethan James Hall | Physician Assistant | 3110 Fairview Dr, Owensboro, KY 42303-2175 | 2019-09-03 |
| Find all providers in OWENSBORO | ||||
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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.