Gregory Harold Blake, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

26558 Issued in TN

Practice address

1924 Alcoa Hwy
U-100
Knoxville, TN 37920-1511

Phone

(865) 544-9351

Fax

(865) 544-9314

NPI assigned

Apr 27, 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 9

Medicare fee-for-service enrollment

Enrolled in TN

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

Family Practice

Education

University of Texas Southwestern Medical School at Dallas, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of TennesseeGroup PAC ID 3072421213, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• University of Tennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1295751386
  Medicare reassignment Care Compare group NPD
• University of Tennessee

  • Family Nurse Practitioner
  • Memphis, TN
  • NPI 1174221337
  NPD
• University of Tennessee

  • Multi-Specialty Clinic/Center
  • Knoxville, TN
  • NPI 1689631137
  NPD
• University of Tennessee

  • Pediatric Clinical Nurse Specialist
  • Knoxville, TN
  • NPI 1366756082
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348790400000",
    "number": "1841257482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "address_2": "U-67",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-544-9352",
            "fax_number": "865-544-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1924 ALCOA HWY",
            "address_2": "U-100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201511",
            "telephone_number": "865-544-9351",
            "fax_number": "865-544-9314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "GREGORY",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "26558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3092066",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3523237",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100011282",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5766020",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEATLH CARE",
            "identifier": "01-41085",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080100419",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1689631137",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "3023731",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "TN0191",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice Laura Blair, NP
• Destiny Sierra Blair
• Kerri Strike Blair
• Lindsi Blair
• Malcolm Blair, PA-C
• Jeneve Samantha Blake
• John R Blake Jr., M.D.
• Kaela Elise Parnell Blake, M.D.
• Keith Allen Blake, PTA
• Michael Blake, B.S.

• Family Medicine Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; 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.