Blake David Lollis, M.D., MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60584660 Issued in WA

Practice address

302 S 10TH Ave
Yakima, WA 98901

Phone

(509) 574-3380

NPI assigned

Sep 7, 2005

Last updated

Sep 7, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Arkansas Health Group

  dba Beebe Family Clinic

  • Family Medicine Physician
  • Beebe, AR
  • NPI 1306886650
  NPD (past)

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1770577553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023521",
            "telephone_number": "509-574-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S 10TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98901",
            "telephone_number": "509-574-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOLLIS",
        "first_name": "BLAKE",
        "middle_name": "DAVID",
        "credential": "M.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60584660",
            "primary": true
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WA",
            "license": "MD60584660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Llamas
• Leanna Lockett
• Mark Loes, SUPD, MBA
• Scott Loescher, M.A.
• Kara Hungate Lolley, N.D.
• Lolly Angel House Afh LLC
• Arleen Lommers
• Alison Cooper Longbottom, PT, PCS
• Thomas Longbottom, D.P.T
• Anthony James Longo, MD

• Family Medicine Physician in Yakima, WA
• Providers in Yakima, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.