Blaker Enterprises Inc

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

90006820N1 Issued in OR

Legal business name

BLAKER ENTERPRISES INC

Practice address

1902 Jefferson St
Suite 2
Eugene, OR 97405-2414

Phone

(541) 284-8882

Fax

(541) 284-2826

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Debra S Blaker, FNP

Title

Owner/Practitioner

Phone

(541) 284-8882

Specialties & licenses 1

Addresses

Other names 1

• Two Rivers Health Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith Blackwell, PT

  • Physical Therapist
  • Eugene, OR
  • NPI 1649531328
  NPD (past)

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512864000000",
    "number": "1831378025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052414",
            "telephone_number": "541-284-8882",
            "fax_number": "541-284-2826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 JEFFERSON ST",
            "address_2": "SUITE 2",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974052414",
            "telephone_number": "541-284-8882",
            "fax_number": "541-284-2826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKER ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2017-12-10",
        "status": "A",
        "authorized_official_last_name": "BLAKER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "541-284-8882",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "90006820N1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Two Rivers Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kellyn Nicole Blaisdell, M.S.
• Derek Michael Blake
• Jay L Blake, NP
• Jennifer Kay Blake, MA
• Kelsey Elizabeth Blake
• Debra Susan Blaker, FNP
• Sagamore James Blakley, PSS
• Quinn Blanchard, PT, DPT
• Martha Blanchet, L.M.T., M.A., C.H.P.
• Carissa Fawn Blank, LPN

• Family Nurse Practitioner in Eugene, OR
• Providers in Eugene, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2017; 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.