Andrea Natalie Blake-McMahon, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

14851R Issued in LA

Practice address

129 Minden Shopping Dr
Minden, LA 71055-2770

Phone

(318) 377-2007

Fax

(318) 377-3099

NPI assigned

Apr 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Andrea Natlalie Blake Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462492800000",
    "number": "1497710792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 GOULD DR",
            "address_2": "STE 1",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711114971",
            "telephone_number": "318-377-2007",
            "fax_number": "318-377-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 MINDEN SHOPPING DR",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710552770",
            "telephone_number": "318-377-2007",
            "fax_number": "318-377-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE-MCMAHON",
        "first_name": "ANDREA",
        "middle_name": "NATALIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2016-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "14851R",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "14851R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1150185",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "BLAKE",
            "middle_name": "NATLALIE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rose T. Biles, MA, LPC
• Bio-Medical Applications of Louisiana, LLC
• Bio-Medical Applications of Louisiana, LLC
• Tanika Black, MA, LPC, BSN, RN
• Evelyne Denise Blackwell, RN
• Dean Boelter, CRNA
• Bolger Family Medicine, Inc
• Joseph E Bolger, M.D.
• Stefanie T Bond, R.D., L.D.N.
• Kimberly Davis Branch, LDN, RD

• Internal Medicine Physician in Minden, LA
• Providers in Minden, LA by specialty
• Internal Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.