Blaze J Burnham, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP30004598 Issued in WA

Practice address

13607 E Sprague Ave
Spokane Valley, WA 99216-0809

Phone

(509) 892-3113

Fax

(509) 892-3663

NPI assigned

Jun 29, 2006

Last updated

Jul 12, 2010By the provider in NPPES

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Whitman Medical Group PS

  • Family Medicine Physician
  • Colfax, WA
  • NPI 1730289596
  NPD
• Public Hospital District No 3 of Whitman County

  dba Whitman Hospital & Medical Center

  • Critical Access Hospital
  • Colfax, WA
  • NPI 1922009448
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1174551022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13607 E SPRAGUE AVENUE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "99206",
            "telephone_number": "509-892-3113",
            "fax_number": "509-892-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13607 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992160809",
            "telephone_number": "509-892-3113",
            "fax_number": "509-892-3663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNHAM",
        "first_name": "BLAZE",
        "middle_name": "J",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30004598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Richard Burke, DDS
• Ryan D Burklund, M.D.
• Jaynee Sue Burks, MSW LICSW
• Oname Oro Burlingame, MD, PHD
• Lori Lynn Burnett, LMP
• Robert B Burr, PHD
• Katherine Grace Busch, MA, LMHCA, CDPT
• Ryan Bushman, DMD
• Bronson Buskett
• Cory Ray Bussey, SUDP

• Family Nurse Practitioner in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.