Tanner Jameson Blake
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 738Henrico, VA 23233-0203
Phone: (435) 218-1198
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1811578214 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | April 16, 2021 |
| Last updated in NPPES | April 16, 2021 |
| Certification date | February 6, 2021 |
| Mailing address | 3501 Cedar Bay Ct Apt 738, Henrico, VA 23233-0203 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| 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 locations | 2 on file with Medicare |
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