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

Tanner Jameson Blake

Individual provider Physician Assistant · NPI 1811578214

Tanner Jameson Blake is a Physician Assistant in Henrico, Virginia. Qualified in 2023, 3 years ago. Practices with Potomac Valley Hospital of W VA , Inc, a 89-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2021

Practice location Address checks out

3501 Cedar Bay Ct Apt 738
Henrico, VA 23233-0203
Phone: (435) 218-1198
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 number1811578214
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 16, 2021
Last updated in NPPESApril 16, 2021
Certification dateFebruary 6, 2021
Mailing address3501 Cedar Bay Ct Apt 738, Henrico, VA 23233-0203

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Potomac Valley Hospital Of W Va , Inc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Henrico