Montana N Blackley, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP60877588 Issued in WA

Practice address

209 Lilly Rd NE
Olympia, WA 98506-5030

Phone

(360) 413-8250

Fax

(360) 413-8850

NPI assigned

Jun 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Regional Anesthesia Associates Inc 143 clinicians

Pain Care Physicians PLLC 13 clinicians

Gastroenterology Associates Clinical Practice PLLC 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Gastroenterology Associates Clinical Practice, PLLC

  • Gastroenterology Physician
  • Olympia, WA
  • NPI 1811556442

  Nurse Anesthetist, Certified Registered, WA

  Medicare reassignment Care Compare group NPD
• Pain Care Physicians PLLC

  • Interventional Pain Medicine Physician
  • Renton, WA
  • NPI 1144779232

  WA

  Medicare reassignment Care Compare group NPD
• Valley Regional Anesthesia Associates Inc

  • Anesthesiology Physician
  • Fresno, CA
  • NPI 1578272415

  WA

  Medicare reassignment Care Compare group NPD
• Anesis Bel-Red ASC, LLC

  • Ambulatory Surgical Clinic/Center
  • Bellevue, WA
  • NPI 1851486195

  Nurse Anesthetist, Certified Registered, WA

  Medicare reassignment NPD
• Pain Care Physicians PLLC

  • Interventional Pain Medicine Physician
  • Olympia, WA
  • NPI 1356960769
  Care Compare group
• Pain Care Physicians PLLC

  • Interventional Pain Medicine Physician
  • Spokane Valley, WA
  • NPI 1548710585
  Care Compare group
• Pain Care Physicians PLLC

  • Interventional Pain Medicine Physician
  • Tacoma, WA
  • NPI 1588113062
  Care Compare group
• Sheridan Healthcare of Washington, PC

  • Anesthesiology Physician
  • Olympia, WA
  • NPI 1386883775

  Nurse Anesthetist, Certified Registered

  NPD (past)
• Tahoma Anesthesiology Consultants PS

  • Anesthesiology Physician
  • Olympia, WA
  • NPI 1699723023
  NPD (past)
• Aaa Anesthesia Associates LLC

  • Anesthesiology Physician
  • Allentown, PA
  • NPI 1134620529

  Nurse Anesthetist, Certified Registered

  NPD (past)

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1386095891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 TRADITIONS AVE NE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985161335",
            "telephone_number": "503-703-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065030",
            "telephone_number": "360-413-8250",
            "fax_number": "360-413-8850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Lilly Rd NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065028",
            "country_code": "US",
            "telephone_number": "206-538-6300",
            "fax_number": "206-538-6301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKLEY",
        "first_name": "MONTANA",
        "middle_name": "N",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "201344",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "22155",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP60877588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Black Hills Pediatrics Inc PS
• Corrin Black
• Joshua Alan Black, CAAR
• Morgan Celeste Black
• Marles Blackbird, LMT
• Wendy Blackman, DNP, ARNP, CPNP-PC
• Kevin Blackmon, MD
• Gregary M Blackner, M.D.
• Abigail Blackwell, NP-C
• Amanda Blades-Serrao

• All providers in Olympia, WA
• Certified Registered Nurse Anesthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.