Tyanna Leigh Blake, R.T.(R)

Primary specialty

Radiologic TechnologistTaxonomy code 247100000X

License

CRT0000104107 Issued in AZ

Practice address

650 E Indian School Rd # RF
Phoenix, AZ 85012-1839

Phone

(602) 277-5551

NPI assigned

Feb 18, 2025

Last updated

Feb 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tyanna Leigh Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1739836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1881499226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 N 50TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853022419",
            "telephone_number": "623-826-5388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E INDIAN SCHOOL RD # RF",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121839",
            "telephone_number": "602-277-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKE",
        "first_name": "TYANNA",
        "middle_name": "LEIGH",
        "credential": "R.T.(R)",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-18",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist",
            "state": "AZ",
            "license": "CRT0000104107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TYANNA",
            "last_name": "WILLIAMS",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda Blake-Johnson
• Lauren Perry Blake, PSYD
• Nadia R Blake
• Raymond Blake III
• Thomas James Blake
• Brooke Mackenzie Blakeman, M.ED., BCBA, LBA
• Doris Blakes-Greenway, ED.D.,OTRL
• Rachel Ewing Blakey, OT
• Jessica Blakley, DO
• Sarah Michelle Blalock

• Radiologic Technologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Radiologic Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.