William J Blake, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

280 Issued in NM

Practice address

2019 Galisteo St Ste K
Santa Fe, NM 87505-2159

Phone

(505) 982-0123

Fax

(505) 982-5714

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Las Vegas Primary Care, Inc

  • Family Medicine Physician
  • Las Vegas, NM
  • NPI 1003053679
  NPD (past)
• Orthopaedic Bone & Joint Specialists PA

  • Orthopaedic Surgery Physician
  • Albuquerque, NM
  • NPI 1780718155
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392336000000",
    "number": "1831100502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST STE K",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052159",
            "telephone_number": "505-982-0123",
            "fax_number": "505-982-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2019 GALISTEO ST STE K",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875052159",
            "telephone_number": "505-982-0123",
            "fax_number": "505-982-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2014-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NM",
            "license": "280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NM005445",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVP11835",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75222353",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HP",
            "identifier": "201035866",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00414656",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Blade, LMSW
• Mary Blair
• Nicol Blais, LMHC
• Carrie Valentine Blake, CPM, LM
• Wendy Blake
• Robert Van Blakeburn, MD
• Margaret Blanchard, RN
• Salvador Blanco
• Alicia Blankenship
• Janet Michelle Blankenship

• Podiatrist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Podiatrist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2014; 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.