MR. BLAKE CALLENDER
Complete NPI Record 1235461963
Physician Assistant in Tacoma, WA
Active since February 05, 2010
Complete NPI Dataset
This page contains the complete raw NPPES record for Mr. Blake Callender (NPI 1235461963), an individual physician assistant provider in Tacoma, WA. All 24 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1235461963 Field 1/24
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/24
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: CALLENDER Field 3/24
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: BLAKE Field 4/24
- The first name of the provider, if the provider is an individual.
- Provider Name Prefix Text: MR. Field 5/24
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider First Line Business Mailing Address: 6675 CORPORATE CENTER PARKWAY Field 6/24
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Second Line Business Mailing Address: SUITE 112 Field 7/24
- The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
- Provider Business Mailing Address City Name: JACKSONVILLE Field 8/24
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: FL Field 9/24
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 322168088 Field 10/24
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/24
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider First Line Business Practice Location Address: 9040 JACKSON AVE Field 12/24
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: TACOMA Field 13/24
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: WA Field 14/24
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 984318088 Field 15/24
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/24
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2539682252 Field 17/24
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 20/24
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363A00000X Field 21/24
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 22/24
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Sole Proprietor: N Field 23/24
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
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