NPIMap

Organization Active NPI

Blake D. Alexander, MD PC

  • Dermatology Physician
  • Modesto, CA
National Provider Identifier
1447588280
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
C52849 Issued in CA
Legal business name
BLAKE D. ALEXANDER, MD PC
Practice address
1101 Standiford Ave
Suite a-3
Modesto, CA 95350-0982
Phone
(209) 578-5072
Fax
(209) 578-5292
NPI assigned
Dec 4, 2009
Last updated
Dec 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Authorized official

Name
Blake D. Alexander, M.D.NPI 1033132170
Title
Owner
Phone
(209) 578-5072

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X C52849 CA Primary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ND0101X C52849 CA

Addresses

Primary practice location

1101 Standiford Ave
Suite a-3
Modesto, CA 95350-0982

Mailing address

1101 Standiford Ave
Suite a-3
Modesto, CA 95350-0982
Phone (209) 578-5072

National Provider Directory

National Provider Directory

Locations

1101 Standiford Ave
Ste A3
Modesto, CA 95350
Phone (209) 578-5072

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1447588280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 STANDIFORD AVE",
            "address_2": "SUITE A-3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500982",
            "telephone_number": "209-578-5072",
            "fax_number": "209-578-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 STANDIFORD AVE",
            "address_2": "SUITE A-3",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953500982",
            "telephone_number": "209-578-5072",
            "fax_number": "209-578-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE D. ALEXANDER, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-578-5072",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "C52849",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "C52849",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.