Debra Susan Blaker, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

090006820N1 Issued in OR

Practice address

1902 Jefferson St
Suite 2
Eugene, OR 97405-2414

Phone

(541) 284-8882

Fax

(541) 284-2826

NPI assigned

Oct 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17276/brand/1/csg/1/fhir/r4

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

• Essential Physical Therapy, Inc.

  • Physical Therapist
  • Eugene, OR
  • NPI 1104210756
  NPD (past)

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1104906981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052414",
            "telephone_number": "541-284-8882",
            "fax_number": "541-284-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052414",
            "telephone_number": "541-284-8882",
            "fax_number": "541-284-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKER",
        "first_name": "DEBRA",
        "middle_name": "SUSAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "090006820N1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derek Michael Blake
• Jay L Blake, NP
• Jennifer Kay Blake, MA
• Kelsey Elizabeth Blake
• Blaker Enterprises Inc
• Sagamore James Blakley, PSS
• Quinn Blanchard, PT, DPT
• Martha Blanchet, L.M.T., M.A., C.H.P.
• Carissa Fawn Blank, LPN
• Shannon N Blanken, RPH

• Family Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.