Individual provider Active NPI

Blake Thomas, DO

  • Family Medicine Physician
  • Muskogee, OK
National Provider Identifier
1669116752
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9323 Issued in OK
Practice address
350 S 40TH St
Muskogee, OK 74401-4915
Phone
(918) 910-4300
Fax
(918) 910-4315
NPI assigned
Apr 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 90200000X IL
Family Medicine Physician 207Q00000X 036171685 IL
Family Medicine Physician 207Q00000X 9323 OK Primary

Addresses

Primary practice location

350 S 40TH St
Muskogee, OK 74401-4915

Mailing address

815 Main St Ste C
Peoria, IL 61602-1080
Phone (309) 672-4977

Other practice location 1

815 Main St Ste C
Peoria, IL 61602-1080
Phone (309) 672-4977

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OK2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250204001589 IL Practitioner - Family Practice 0446780605 Reassigns benefits to 2 organizations
I20251008000281 OK Practitioner - Family Practice 0446780605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Liberty Univ College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Clinic IncGroup PAC ID 8820900293, 787 clinicians
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, 387 clinicians

Practice addresses (Care Compare)

300 Rockefeller Dr
Muskogee, OK 74401-5075
Phone (918) 684-2187

815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977

Hospital & facility affiliations

  • A Path of Care Sooner Home Health Home health agency, Muskogee, OK, CCN 377722
  • Saint Francis Hospital Muskogee Hospital, Muskogee, OK, CCN 370025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036171685ILMDFamily Medicine Physician
90200000XILMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Clinic Inc CurrentSince Oct 27, 2025 Accepting new patients
Methodist Medical Center of Illinois Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jan 1, 2025 Accepting new patients
Proctor Health Systems Family Medicine CurrentSince Jan 1, 2025 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A1
Peoria, IL 61602

120 NE Glen Oak Ave
Peoria, IL 61603
Phone (309) 672-3158

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

815 Main St
Ste C
Peoria, IL 61602
Phone (309) 672-4986

300 Rockefeller Dr
Muskogee, OK 74401
Phone (918) 682-5501

350 S 40th St
Muskogee, OK 74401
Phone (918) 683-0753

6600 S Yale Ave
Ste 1400
Tulsa, OK 74136
Phone (888) 247-0125

6161 S Yale Ave
Tulsa, OK 74136
Phone (918) 494-2200

Interoperability endpoints

  • Direct secure messaging: bthomas248905@direct.saintfrancis.com
  • Direct secure messaging: bthomasdo388612@carlehiedirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1669116752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MAIN ST STE C",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021080",
            "telephone_number": "309-672-4977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S 40TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744014915",
            "telephone_number": "918-910-4300",
            "fax_number": "918-910-4315"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Main St Ste C",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616021080",
            "country_code": "US",
            "telephone_number": "309-672-4977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "BLAKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-25",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": "90200000X",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036171685",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "9323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.