NPIMap

Individual provider Active NPI

John P Blakely, DO

  • Addiction Medicine (Anesthesiology) Physician
  • San Antonio, TX
National Provider Identifier
1619945839
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Anesthesiology) PhysicianTaxonomy code 207LA0401X
License
L2144 Issued in TX
Practice address
3615 Culebra Road
San Antonio, TX 78228
Phone
(210) 314-6473
Fax
(210) 314-8676
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 2003007037 MO
Anesthesiology Physician 207L00000X L2144 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X 2003007037 MO
Addiction Medicine (Anesthesiology) Physician 207LA0401X L2144 TX Primary

Addresses

Primary practice location

3615 Culebra Road
San Antonio, TX 78228

Mailing address

7970 Fredericksburg Rd
PMB #101-175
San Antonio, TX 78229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070206000548 TX Practitioner - Anesthesiology 1456346378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2003007037MOMDAnesthesiology Physician
L2144TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healogics Specialty Physicians of Texas, PLLC Anesthesiology CurrentSince Nov 13, 2017 Accepting new patients
Wellness One Memphis PC CurrentSince Aug 1, 2017 Accepting new patients
Medmark Treatment Centers of Texas, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Anesthesia Care of Bloomington PC Anesthesiology Past Accepting new patients
Chillicothe Anesthesia Associates Inc Anesthesiology Past Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients
Hannibal Regional Healthcare System Inc Past Accepting new patients
Celldox Inc Past Accepting new patients
Monroe Physicians Group Past Accepting new patients
Ozark Anesthesia Associates, Inc. Anesthesiology PastSince Jun 17, 2002 Accepting new patients
Metro Treatment of Texas LP PastSince Oct 27, 2024 Accepting new patients
Licking Memorial Professional Corporation Anesthesiology Past Accepting new patients
Gulfstream Anesthesia Associates, P. a. Anesthesiology Past Accepting new patients

Locations

5220 Belfort Rd
Ste 130
Jacksonville, FL 32256
Phone (904) 446-3686

6100 E Primacy Pkwy
Ste 112
Memphis, TN 38119
Phone (901) 682-5335

1105 Central Expy N
Ste 2210
Allen, TX 75013
Phone (972) 747-4325

618 S Grove St
Marshall, TX 75670
Phone (903) 927-6725

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1619945839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7970 FREDERICKSBURG RD",
            "address_2": "PMB #101-175",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 CULEBRA ROAD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78228",
            "telephone_number": "210-314-6473",
            "fax_number": "210-314-8676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MO",
            "license": "2003007037",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "L2144",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MO",
            "license": "2003007037",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "TX",
            "license": "L2144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.