John Vayden Blake, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

929 Issued in WV

Practice address

315 Fairview Heights Rd
Summersville, WV 26651-1086

Phone

(304) 469-2905

Fax

(304) 465-5486

NPI assigned

Dec 30, 2005

Last updated

Jan 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

New River Health Association IncGroup PAC ID 2365348596, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science, Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.blake.1@16450.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• New River Health Association, Inc.

  dba New River Health - Summersville

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1407394646
  Medicare reassignment Care Compare group NPD
• Monongahela Valley Association of Health Centers, Inc

  dba MVA Fairmont Clinic

  • Federally Qualified Health Center (FQHC)
  • Fairmont, WV
  • NPI 1770697278
  Medicare reassignment
• New River Health Association, Inc.

  dba New River Health - Oak Hill

  • Federally Qualified Health Center (FQHC)
  • Oak Hill, WV
  • NPI 1386318756
  Medicare reassignment
• West Virginia University Medical Corporation

  dba University Health Associates

  • Family Medicine Physician
  • Morgantown, WV
  • NPI 1275504508
  Medicare reassignment
• New River Health Association, Inc.

  dba New River Health Harper Road

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1033088331
  NPD
• New River Health Association, Inc.

  dba New River Health - Beckley

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1063275519
  NPD
• New River Health Association, Inc.

  dba Nicholas County School Based Health Center

  • Federally Qualified Health Center (FQHC)
  • Summersville, WV
  • NPI 1689669855
  NPD
• West Virginia University Medical Corporation

  dba Crisis Support and Recovery Center

  • Community/Behavioral Health Agency
  • Martinsburg, WV
  • NPI 1174233530
  NPD
• West Virginia University Medical Corporation

  • Family Medicine Physician
  • Ranson, WV
  • NPI 1215785563
  NPD
• New River Health Association, Inc.

  dba New River Health - Scarbro

  • Federally Qualified Health Center (FQHC)
  • Scarbro, WV
  • NPI 1811983331
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1013994953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 MALL RD",
            "city": "OAK HILL",
            "state": "WV",
            "postal_code": "259016216",
            "telephone_number": "304-469-2905",
            "fax_number": "304-465-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 FAIRVIEW HEIGHTS RD",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511086",
            "telephone_number": "304-469-2905",
            "fax_number": "304-465-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "JOHN",
        "middle_name": "VAYDEN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "929",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WV",
            "license": "202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenna Leann Bennett
• Tina Lee Bennett
• Bonnie Sue Bess
• Danielle Billops
• Mason Bishop, DDS
• Sanda Blayney
• Whitney Boggs, M.D.
• Judith Boley
• Howard Stephen Boone, R.PH.
• Tori Boone, LPN

• Physician Assistant in Summersville, WV
• Providers in Summersville, WV by specialty
• Physician Assistant in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.