Blake David Jeffres, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

4074 Issued in NE

Practice address

2728 N 108TH St Ste 103
Omaha, NE 68164-3763

Phone

(402) 939-7939

Fax

(402) 939-7939

NPI assigned

Aug 28, 2020

Last updated

Sep 16, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

University of Nebraska College of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rock Valley Physical Therapy CenterGroup PAC ID 9638087877, 232 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rock Valley Physical Therapy Center

  • Physical Therapist
  • Moline, IL
  • NPI 1245373166

  NE, Sports

  Medicare reassignment Care Compare group NPD
• Rock Valley Physical Therapy Center

  • Occupational Therapist
  • Eldridge, IA
  • NPI 1881540490
  NPD

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1427661495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 N 108TH ST",
            "address_2": "STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643763",
            "telephone_number": "402-939-7939",
            "fax_number": "402-939-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 N 108TH ST STE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681643763",
            "telephone_number": "402-939-7939",
            "fax_number": "402-939-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRES",
        "first_name": "BLAKE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NE",
            "license": "4074",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NE",
            "license": "4074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tavonna Jefferson
• Timothy L Jefferson
• Vera Krystell Jefferson, LPN
• William Howard Jefferson Sr.
• Alexis Jeffres
• Jeffrey a Passer MD PC
• Jeffrey D. Krenzer Counseling and Consulting Services P.C.
• Jeffrey J Schroeder, DDS PC
• Christine M Jeffrey, M.D.
• Cynthia R Jeffrey, LMHP

• Orthopedic Physical Therapist in Omaha, NE
• Providers in Omaha, NE by specialty
• Orthopedic Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.