Mark Wade Blakeley, MSC, EMT-P

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

17155 Holyoke Court
Parker, CO 80134

Phone

(303) 601-5761

NPI assigned

Feb 18, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician - Paramedic

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

{
    "created_epoch": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1235307729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17155 HOLYOKE CT",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801349136",
            "telephone_number": "303-601-5761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17155 HOLYOKE COURT",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "80134",
            "telephone_number": "303-601-5761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELEY",
        "first_name": "MARK",
        "middle_name": "WADE",
        "name_prefix": "Mr.",
        "credential": "MSC, EMT-P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-18",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": null,
            "primary": true
        },
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "CO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMEDIC CERTIFICATION",
            "identifier": "2791",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Bixby, RPH
• Louise Bixby, RPH
• Emilie Louise Bjerring, DMD
• Amy Black-Ryel, MA, CCC-SLP
• Aeryn Blake
• Kristin Blanchard
• Rachael Evangeline Blaske
• Joseph Paul Blatchford, CRT
• Angela Michelle Blevins, PA-C
• Bliss Behavioral Health PLLC

• Professional Counselor in Parker, CO
• Providers in Parker, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.