Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Donald Jordan, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043899248

Blake Donald Jordan, DO is an Internal Medicine in LA Crosse, Wisconsin. Qualified in 2021, 5 years ago. Practices with Gundersen Lutheran Medical Center Inc, a 896-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Wisconsin.

Years since qualifying
5
Licensed in
WI
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1836 S Ave
LA Crosse, WI 54601-5429
Phone: (608) 782-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 77519 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1043899248
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 5, 2021
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024
Mailing address1836 South Ave, La Crosse, WI 54601-5429

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Gundersen Lutheran Medical Center Inc — 896 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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