NPIMap

Individual provider Active NPI

Dennis N Blake, M.D.

  • Family Medicine Physician
  • Piggott, AR
National Provider Identifier
1720095599
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E2311 Issued in AR
Practice address
425 W Jackson St
Piggott, AR 72454-1538
Phone
(870) 598-2236
Fax
(870) 598-3080
NPI assigned
Aug 2, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E2311 AR Primary

Addresses

Primary practice location

425 W Jackson St
Piggott, AR 72454-1538

Mailing address

425 W Jackson St
Piggott, AR 72454-1538
Phone (870) 598-2236

Other identifiers 2

IdentifierTypeStateIssuer
141033001MedicaidAR
205038201MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20100601000611 AR Practitioner - Family Practice 7214944487 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piggott Community HospitalGroup PAC ID 0345140448, shared by 8 NPIs, 10 clinicians
Doctors Health Group, IncGroup PAC ID 7315844586, 23 clinicians

Practice addresses (Care Compare)

1206 Gordon Duckworth Dr
Piggott, AR 72454-1911
Phone (870) 598-3881

425 W Jackson St
Piggott, AR 72454-1538

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E2311ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Health Group, Inc Family Medicine Current Accepting new patients
St Bernards Physician Clinics Inc Current Accepting new patients
Doctors Health Group, Inc Family Medicine CurrentSince Feb 22, 2014 Accepting new patients
Piggott Community Hospital Family Medicine CurrentSince Nov 21, 2009 Accepting new patients
Piggott Community Hospital CurrentSince Nov 21, 2009 Accepting new patients

Locations

1206 Gordon Duckworth Dr
Piggott, AR 72454
Phone (870) 598-3881

425 W Jackson St
Piggott, AR 72454
Phone (870) 598-2236

Interoperability endpoints

  • Direct secure messaging: dennisblake@sbpc.medalliesdirect.net

Organizations & group practices 5

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.

Hospital & facility affiliations 8

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1720095599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 W JACKSON ST",
            "city": "PIGGOTT",
            "state": "AR",
            "postal_code": "724541538",
            "telephone_number": "870-598-2236",
            "fax_number": "870-598-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 W JACKSON ST",
            "city": "PIGGOTT",
            "state": "AR",
            "postal_code": "724541538",
            "telephone_number": "870-598-2236",
            "fax_number": "870-598-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DENNIS",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E2311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141033001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205038201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piggott, AR

Sources for this page

Verify at the official NPI Registry.