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

Individual provider Certified Registered Nurse Anesthetist · NPI 1649717091

Blake Randall Ridgway, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Durant, Oklahoma. Qualified in 2017, 9 years ago. Practices with Alisan Anesthesia Associates PLLC, a 4-clinician group and accepts Medicare assignment. Licensed in Oklahoma and Texas.

Years since qualifying
9
Licensed in
OK, TX
In the registry since
2017
Specialties on file
2
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

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Practice location Address checks out

1800 W University Blvd
Durant, OK 74701-3006
Phone: (281) 249-5954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 100088 (OK)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 826001 (TX)

Record details

NPI number1649717091
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorYes
NPI enumeratedJanuary 24, 2017
Last updated in NPPESJanuary 24, 2017

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Alisan Anesthesia Associates Pllc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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