Ian David Blake, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT3742 Issued in OK

Practice address

6767 S Yale Ave
Suite B
Tulsa, OK 74136-3302

Phone

(918) 494-3000

Fax

(918) 494-0003

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

No

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

Enrolled in OK

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tulsa PT Consultants, LLCGroup PAC ID 9638211691, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tulsa PT Consultants, LLC

  • Orthopedic Physical Therapist
  • Tulsa, OK
  • NPI 1689901852
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1124094479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 S YALE AVE",
            "address_2": "SUITE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363302",
            "telephone_number": "918-494-3000",
            "fax_number": "918-494-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 S YALE AVE",
            "address_2": "SUITE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363302",
            "telephone_number": "918-494-3000",
            "fax_number": "918-494-0003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "IAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "PT3742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Calvin Blair III
• Emily Grace Blais
• Blake Allen Little, M.D., L.L.C.
• Christine Faith Blake, MD
• George Jacob Blake, MD
• Kristen Nicole Blake
• Samantha Jo Blake
• Jesse Blaker
• Monica Blakley
• Sarah Blakley

• Physical Therapist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.