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

Kori Blake

Individual provider Physician Assistant · NPI 1790553576

Kori Blake is a Physician Assistant in Glen Dale, West Virginia. Qualified in 2024, 2 years ago. Practices with West Virginia University Medical Corporation, a 1,981-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
2
In the registry since
2023

Practice location Address checks out

1107 Glen Dale Heights Rd
Glen Dale, WV 26038-1092
Phone: (304) 281-4344
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1790553576
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 12, 2023
Last updated in NPPESDecember 12, 2023
Certification dateDecember 12, 2023
Mailing address1107 Glen Dale Heights Rd, Glen Dale, WV 26038-1092

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice West Virginia University Medical Corporation — 1981 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Glen Dale