NPIMap

Organization Active NPI

Blake D. Alexander, MD, PA

  • Dermatology Physician
  • Pocatello, ID
National Provider Identifier
1366626483
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
M8227 Issued in ID
Legal business name
BLAKE D. ALEXANDER, MD, PA
Practice address
500 S 11TH Ave
Suite 203
Pocatello, ID 83201-4835
Phone
(208) 236-1600
Fax
(208) 236-6695
NPI assigned
Dec 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
Blake D. Alexander, MDNPI 1033132170
Title
President
Phone
(208) 236-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X M8227 ID Primary

Addresses

Primary practice location

500 S 11TH Ave
Suite 203
Pocatello, ID 83201-4835

Mailing address

PO Box 4908
Pocatello, ID 83205-4908
Phone (208) 236-1600

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1366626483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4908",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054908",
            "telephone_number": "208-236-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 S 11TH AVE",
            "address_2": "SUITE 203",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014835",
            "telephone_number": "208-236-1600",
            "fax_number": "208-236-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE D. ALEXANDER, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-236-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M8227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.