Blake Geschke

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601008070 Issued in MI

Practice address

2776 S State Rd
Ionia, MI 48846-8472

Phone

(616) 775-7500

NPI assigned

Dec 30, 2016

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Wellstreet Urgent Care of Michigan

  • Urgent Care Clinic/Center
  • West Bloomfield, MI
  • NPI 1578048096
  Medicare reassignment
• Pennock Hospital

  • Family Medicine Physician
  • Hastings, MI
  • NPI 1518186295
  NPD (past)
• Wellstreet Urgent Care of Michigan

  • Non-Pharmacy Dispensing Site
  • Troy, MI
  • NPI 1649952052
  NPD (past)

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

{
    "created_epoch": "1483056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1710422696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2776 S STATE RD",
            "city": "IONIA",
            "state": "MI",
            "postal_code": "488468472",
            "telephone_number": "616-775-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESCHKE",
        "first_name": "BLAKE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-30",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601008070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Gaskin
• James Geisen, LMSW
• Sheila Marie Gendich, M.D.
• Gerald L Almy II OD PLLC
• Nathan Gertz, RPH
• Klista Gillean
• Donald J Gingerich, D.O.
• Goodwill Optical Inc
• Jamie Lynn Gothberg, NP
• Grace Counseling of Mid-Michigan LLC

• Physician Assistant in Ionia, MI
• Providers in Ionia, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.