BLAKE SURGICAL ASSOCIATION PLLC – NPI #1154521466
Surgery

A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.

BLAKE SURGICAL ASSOCIATION PLLC is a surgeon located in CLEVELAND, MS. NPPES has assigned the NPI number 1154521466 to BLAKE SURGICAL ASSOCIATION PLLC on July 24, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0102X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Surgical Critical Care

The NPI profile was previously updated about 6 years ago on Aug 30, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLAKE SURGICAL ASSOCIATION PLLC below.

NPI Profile for
BLAKE SURGICAL ASSOCIATION PLLC

NPI Number
1154521466
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLAKE SURGICAL ASSOCIATION PLLC
Primary location
907 E SUNFLOWER RD #101
CLEVELAND, MS 38732-2833
Phone: (662) 846-8880 Fax:
Mailing address
907 E SUNFLOWER RD
101
CLEVELAND, MS 38732-2830
Phone: (662) 846-8880 Fax: (662) 846-8886
Organization Subpart
No
Authorized Official
ROGER BLAKE
OWNER/PHYSICIAN
Phone: (662) 846-8880
Updated
Certification Date
Aug 30, 2020

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for BLAKE SURGICAL ASSOCIATION PLLC

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERMEDICARE GROUP #MSC03406
OTHERMEDICARE PROVIDER #MS020000545
MEDICAIDMS00122620
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0102X
- Surgery / Surgical Critical Care (Primary)
MS 16881
208600000X
- Surgery
MS 16881

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.