James Eldridge Blaine Jr., DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

36003408 Issued in OH

Practice address

355 E Campus View Blvd
Suite 175
Columbus, OH 43235-5616

Phone

(614) 987-1424

Fax

(855) 252-4451

NPI assigned

Sep 11, 2006

Last updated

Jul 10, 2014By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404950400000",
    "number": "1942304027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4839",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480994839",
            "telephone_number": "248-824-6600",
            "fax_number": "855-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 E CAMPUS VIEW BLVD",
            "address_2": "SUITE 175",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432355616",
            "telephone_number": "614-987-1424",
            "fax_number": "855-252-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAINE",
        "first_name": "JAMES",
        "middle_name": "ELDRIDGE",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2014-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2553062",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "9354431",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ronnetta Blackwell, RN
• Tatyana Blackwell
• Stephanie Beth Blades, LISW-S
• Erin Blaemire
• Hailey Blaine
• Ashley Blair-Cunningham, LPN
• Alex Bryant Blair, MD
• Charmaine M Blair, M.D.
• Cheyenne Blair
• Kimberly Rachel Blair

• Podiatrist in Columbus, OH
• Providers in Columbus, OH by specialty
• Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.