Active NPI
Christopher A. Blake, M.D.
- Orthopaedic Surgery Physician
- McMinnville, OR
National Provider Identifier
1962450601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 10783
- Practice address
- 355 SE Baker St
McMinnville, OR 97128-6039 - Phone
- (503) 472-0423
- Fax
- (503) 472-4325
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 10783 | OR | Primary |
Addresses
Primary practice location
355 SE Baker St
McMinnville, OR 97128-6039
Mailing address
355 SE Baker St
McMinnville, OR 97128-6039
Phone (503) 472-0423
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228452 | Medicaid | OR | |
| 930805004 | Other | TAX ID | |
| 200001052 | Other | OR | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10783 | OR | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willamette Valley Clinics LLC | Orthopaedic Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- McMinnville, OR
- NPI 1790740520
Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223337600000",
"number": "1962450601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 SE BAKER ST",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971286039",
"telephone_number": "503-472-0423",
"fax_number": "503-472-4325"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 SE BAKER ST",
"city": "MCMINNVILLE",
"state": "OR",
"postal_code": "971286039",
"telephone_number": "503-472-0423",
"fax_number": "503-472-4325"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAKE",
"first_name": "CHRISTOPHER",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2008-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OR",
"license": "10783",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "228452",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "930805004",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200001052",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in McMinnville, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.