MR. BLAKE JOHN CARDEN PA-C, NPI 1073983870 — NASHVILLE (TN)

NPI 1073983870

4+ Years Experience Individual

MR. BLAKE JOHN CARDEN PA-C

10.06.2015
PROVIDER ENUMERATION DATE
01/29/2018
LAST UPDATE DATE
1073983870
NPI NUMBER

About MR. BLAKE JOHN CARDEN

Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.

MR. BLAKE JOHN CARDEN is a provider established in NASHVILLE, TN. The NPI number of MR. BLAKE JOHN CARDEN is 1073983870 and was assigned on 10.06.2015. The practitioners primary taxonomy code is: 363AM0700X .

Mailing address

  • City: NASHVILLE
  • State: TN
  • Postal code: 372043708
  • Phone: 6156951432
  • Fax: 6156951483
  • Address: 608 NORRIS AVE

Primary Practice Address

  • Region : NASHVILLE, TN
  • NPI : 1073983870
  • Phone : 6153210200
  • Fax : 6156203266
  • Postalcode : 372032656
  • Address : 2004 HAYES ST STE 650

Provider taxonomy - Physician Assistant

  • Taxonomy code: 363AM0700X

The taxonomy is not the primary taxonomy.

Healthcare provider taxonomy #2 - Physician Assistant

  • Taxonomy code: 363AS0400X
  • License number: 2878
  • License state: TN

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MR. BLAKE JOHN CARDEN PA-C
  • Address : 2004 HAYES ST STE 650
  • Region : NASHVILLE, TN
  • NPI : 1073983870
  • Phone : 6153210200
  • Fax : 6156203266
  • Postalcode : 372032656

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address2004 HAYES ST STE 650
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNASHVILLE
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTN
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code372032656
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number6153210200
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number6156203266
The fax number associated with the location address of the provider being identified.
NPI1073983870
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363AM0700X
Provider Enumeration Date10.06.2015
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated01/29/2018
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)MR. BLAKE JOHN CARDEN
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address608 NORRIS AVE
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameNASHVILLE
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTN
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code372043708
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number6156951432
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number6156951483
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1363AM0700X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Physician Assistant
Healthcare Provider Primary Taxonomy Switch 1N
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Healthcare Provider Taxonomy Code 2363AS0400X
Healthcare Provider Taxonomy 2Physician Assistant
Provider License Number 22878
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 2TN
Healthcare Provider Primary Taxonomy Switch 2Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorN
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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