Individual provider Active NPI

Dana Daniel Blake, PT

  • Physical Therapist
  • Bessemer, AL
National Provider Identifier
1770662660
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH2382 Issued in AL
Practice address
975 9TH Ave SW Ste 320
Bessemer, AL 35022-7839
Phone
(205) 277-2358
NPI assigned
Nov 3, 2006
Last updated
May 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X GA006565 GA
Physical Therapist 225100000X PTH2382 AL Primary

Addresses

Primary practice location

975 9TH Ave SW Ste 320
Bessemer, AL 35022-7839

Mailing address

405 Belcher St
Centreville, AL 35042-2946
Phone (205) 926-2992

Other practice location 1

1431 White Cir
Suite C
Marietta, GA 30066-5801
Phone (770) 426-9945

Other identifiers 1

IdentifierTypeStateIssuer
GA006565OtherGASTATE LISC NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GA006565GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1770662660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 BELCHER ST",
            "city": "CENTREVILLE",
            "state": "AL",
            "postal_code": "350422946",
            "telephone_number": "205-926-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 9TH AVE SW STE 320",
            "city": "BESSEMER",
            "state": "AL",
            "postal_code": "350227839",
            "telephone_number": "205-277-2358"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1431 White Cir",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300665801",
            "country_code": "US",
            "telephone_number": "770-426-9945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "DANA",
        "middle_name": "DANIEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "GA006565",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "GA006565",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bessemer, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.