Take Aim Psychotherapy

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS10255 Issued in FL

Legal business name

TAKE AIM PSYCHOTHERAPY

Practice address

741 S Beneva Rd
Sarasota, FL 34232-2411

Phone

(941) 387-4070

Fax

(941) 922-4742

NPI assigned

Jun 9, 2017

Organization subpart

No

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

Authorized official

Name

Wayne S Blake, DONPI 1588661185

Title

Owner

Phone

(941) 387-4070

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wayne S Blake, D.O.

  • Internal Medicine Physician
  • Sarasota, FL
  • NPI 1588661185
  NPD (past) Authorized official

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

{
    "created_epoch": "1496966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496966400000",
    "number": "1861921199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15342",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342771342",
            "telephone_number": "941-387-4070",
            "fax_number": "941-922-4742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 S BENEVA RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322411",
            "telephone_number": "941-387-4070",
            "fax_number": "941-922-4742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAKE AIM PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-09",
        "last_updated": "2017-06-09",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-387-4070",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280257100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "OS10255",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marnie Anne Tafferner, OTR
• Kevin A Tagle, CRNA
• Susan J Tagle, CRNA
• Giani Tah
• Katanya Taite, LMT
• Take Care of Sarasota Inc.
• Scott D Talbert, PA
• Tallahassee Mobile Wound Care LLC
• Sudha Tallapragada, MD
• Nicholas Talluri, MD

• Internal Medicine Physician in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.