Blaine Fisk, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

AP61257123 Issued in WA

Practice address

2655 Northwinds Pkwy
Alpharetta, GA 30009-2280

Phone

(770) 643-5619

NPI assigned

Dec 27, 2021

Sex

Male

Sole proprietor

Yes

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

Enrolled in ID, OR2 enrollments

Enrollment records 2

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Group practices

West Idaho Anesthesia, LLPGroup PAC ID 9133343031, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• West Idaho Anesthesia, LLP

  • Certified Registered Nurse Anesthetist
  • Caldwell, ID
  • NPI 1871918318

  Nurse Anesthetist, Certified Registered, OR

  Medicare reassignment Care Compare group NPD
• Anesthesia Consulting Partners Idaho, PC

  • Anesthesiology Physician
  • Caldwell, ID
  • NPI 1568241362

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesiology Consultants of Treasure Valley PLLC

  • Anesthesiology Physician
  • Boise, ID
  • NPI 1124066063
  Medicare reassignment NPD

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1821758202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 COMSTOCK ST",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993524528",
            "telephone_number": "208-741-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 NORTHWINDS PKWY",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092280",
            "telephone_number": "770-643-5619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "BLAINE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-27",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60701046",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP61257123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ellen Fisher, LCSW
• Lauren Michele Fisher, PA-C
• Leigh Ann Fisher, LCSW
• Shakaelah Fisher
• Stephen Ronald Fisher, MD
• Adrienne Fitzpatrick, PHARMD
• Diamond Alaysia Fix
• Paige Flanagan, DPT
• Rick L Flateau, MS, ATC, CSCS
• Sarah S Flatland, BCBA

• Certified Registered Nurse Anesthetist in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Certified Registered Nurse Anesthetist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.