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

Blake Wollam

Individual provider Family Nurse Practitioner · NPI 1013643048

Blake Wollam is a Nurse Practitioner in Mentor, Ohio. Qualified in 2022, 4 years ago. Practices with Cleveland Clinic, a 6,935-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Licensed in
OH
In the registry since
2022

Practice location Address checks out

7060 Wayside Dr
Mentor, OH 44060-6527
Phone: (440) 357-2770
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0031396 (OH)

Record details

NPI number1013643048
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 1, 2022
Last updated in NPPESAugust 1, 2022
Certification dateJuly 31, 2022
Mailing address2157 Lakeland Ave, Lakewood, OH 44107-5715

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Cleveland Clinic — 6935 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mentor