Thomas Duvall Blake, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101034259 Issued in VA

Practice address

7255 Hanover Green Dr
Mechanicsville, VA 23111-1706

Phone

(804) 730-1111

Fax

(804) 730-9764

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1528025012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7255 HANOVER GREEN DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111706",
            "telephone_number": "804-730-1111",
            "fax_number": "804-730-9764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7255 HANOVER GREEN DR",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111706",
            "telephone_number": "804-730-1111",
            "fax_number": "804-730-9764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "THOMAS",
        "middle_name": "DUVALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101034259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5644097",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Webb Blackburn, PHD
• M Lee Blackburn, MD
• Cynthia Bresko Blair
• Edsel Dean Blair, DDS
• Lori Blair, P.T.
• Amma Ankwah Boafo, NP
• Lia Boggs
• Wendy Boggs
• Alison Bollander
• Steve Bolling, LPTA

• All providers in Mechanicsville, VA
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.