Active NPI
Michael Paul Blair, PT
- Physical Therapist
- Nome, AK
National Provider Identifier
1780001727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2739
- Practice address
- 1000 Greg Kruschek Ave
Nome, AK 98762 - Phone
- (907) 443-4513
- NPI assigned
- Mar 27, 2014
- Last updated
- Mar 27, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2739 | AK | Primary |
Addresses
Primary practice location
1000 Greg Kruschek Ave
Nome, AK 98762
Mailing address
2049 N D St
Fremont, NE 68025-3031
Phone (402) 719-7508
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Creighton University School of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
122 1St Ave
Fairbanks, AK 99701-4871
Phone (907) 452-8251
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2739 | AK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Holistic Pain Management of Wyoming, LLC | Past | Accepting new patients |
Interoperability endpoints
- michael.blair.1@15989.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Family Nurse Practitioner
- Riverton, WY
- NPI 1487295846
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1780001727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2049 N D ST",
"city": "FREMONT",
"state": "NE",
"postal_code": "680253031",
"telephone_number": "402-719-7508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 GREG KRUSCHEK AVE",
"city": "NOME",
"state": "AK",
"postal_code": "98762",
"telephone_number": "907-443-4513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR",
"first_name": "MICHAEL",
"middle_name": "PAUL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-03-27",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AK",
"license": "2739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nome, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.