Blake Keith Staker, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC009656 Issued in PA

Practice address

46 South 18TH Street
Columbia, PA 17512

Phone

(717) 681-0198

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

ChiropracticAlso: Diagnostic Radiology, Physical Medicine and Rehabilitation

Education

Palmer College Chiropractic - Davenport, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Susquehanna Spine & Joint Center

  • Chiropractor
  • Columbia, PA
  • NPI 1679964332
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790791580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 UNION STREET",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17603",
            "telephone_number": "563-340-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 SOUTH 18TH STREET",
            "city": "COLUMBIA",
            "state": "PA",
            "postal_code": "17512",
            "telephone_number": "717-681-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAKER",
        "first_name": "BLAKE",
        "middle_name": "KEITH",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC009656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Shultz, MS, LPC
• Amanda Lee Sleighter, LSW
• Megan Solyak, PA-C
• Anthony Charles Sottile, DPM
• St. Anne'S Retirement Community, Inc.
• Stephen S Perry DDS LTD
• Story of Things Therapy & Consulting
• Susquehanna Operator, LLC
• Susquehanna Rehabilitation & Wellness Center LLC
• Susquehanna Spine & Joint Center

• Chiropractor in Columbia, PA
• Providers in Columbia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.