Kathleen Blake, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

88-7 Issued in NM

Practice address

502 Elm St NE
Albuquerque, NM 87102-2512

Phone

(505) 841-1000

Fax

(505) 843-2853

NPI assigned

Jun 1, 2005

Last updated

Jan 5, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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.

• New Mexico Heart Institute, LLC

  • Cardiovascular Disease Physician
  • Albuquerque, NM
  • NPI 1346242575
  NPD
• Eecp LLC

  • Cardiovascular Disease Physician
  • Santa Fe, NM
  • NPI 1689795635
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1649272808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8387",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871988387",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022512",
            "telephone_number": "505-841-1000",
            "fax_number": "505-843-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NM",
            "license": "88-7",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "NM",
            "license": "88-7",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03194",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randy Lynn Blair, D.C.
• Traci Gae Blair, R.N,.
• Traci Lee Blair, P.T.
• Travis Anton Blair
• Shawn Blaisdell, CFNP, CNM
• Cloyce Elizabeth Blakely, PA-C
• F Adele Blakely, MD
• Robert Anthony Blakely, MD
• Katharine Anne Blaker, M.S., CCC-SLP
• Kristina Jean Blakney, LMSW

• Clinical Cardiac Electrophysiology Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Clinical Cardiac Electrophysiology Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.