Jerry W Blakely II, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Practice address

2200 Ironwood PL
Coeur D Alene, ID 83814-2610

Phone

(208) 667-6486

NPI assigned

Jun 27, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891992657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 IRONWOOD PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142610",
            "telephone_number": "208-667-6486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 IRONWOOD PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142610",
            "telephone_number": "208-667-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAKELY",
        "first_name": "JERRY",
        "middle_name": "W",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jean Bjorn, LCSW
• Kendra Mae Black-Smith, MD
• Robert Blackston, CST, CSFA
• Chelsea Petrina Blackstone, LMSW
• Leslie Jason Blain
• Erin Blakley
• Douglas Blaty, D.O.
• Robert Ernest Blease, MD
• Sonya Thomas Blizzard, M.D.
• Cherilee C Bloom, DDS

• Orthopedic Physical Therapist in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Orthopedic Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.