Nicole Marie Blake, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23660 Issued in MD

Practice address

4924 Campbell Blvd
Baltimore, MD 21236-5908

Phone

(443) 442-2050

NPI assigned

Jun 16, 2011

Sex

Female

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 MA, MD2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Lifebridge Sports Medicine and Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Eldersburg, MD
  • NPI 1578055497
  Medicare reassignment NPD
• DG Physical Therapy PC

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Chelmsford, MA
  • NPI 1295279198

  Physical Therapist

  Medicare reassignment NPD
• Physiotherapy Associates Inc

  • Rehabilitation Clinic/Center
  • East Harwich, MA
  • NPI 1629165634
  Medicare reassignment NPD
• Lifebridge Sports Medicine & Rehabilitation, LLC

  dba Lifebridge Health Physical Therapy

  • Rehabilitation Clinic/Center
  • Towson, MD
  • NPI 1699006106
  NPD
• Lifebridge Sports Medicine and Rehabilitation LLC

  dba Novacare Rehabilitation

  • Physical Therapy Clinic/Center
  • Baltimore, MD
  • NPI 1750966602
  NPD
• DG Physical Therapy, P.C.

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • North Grafton, MA
  • NPI 1881270544
  NPD
• Physiotherapy Associates Inc

  • Physical Therapy Clinic/Center
  • East Wareham, MA
  • NPI 1497836654
  NPD
• Physiotherapy Associates Inc

  dba Select Physical Therapy

  • Physical Therapy Clinic/Center
  • Estero, FL
  • NPI 1720039902
  NPD

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

{
    "created_epoch": "1308182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1750676904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 S DECKER AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "443-442-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-16",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alvin Douglas Blake Jr.
• Jeanine Marie-Byrne Blake, LCSW-C
• King Blake, L.C.P.C.
• Margaret Ann Blake, RN MSN CRNP
• Nicole Blake
• Otia Blake
• Paris M Blake
• Jaishri O'Neill Blakeley, MD
• Allison Blakely, RN BSN
• Briana Danielle Blakely

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.