Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
TIMOTHY E. BLAKE
Active
Individual
TIMOTHY E. BLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305208076
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1649602723
MEDICAID QMB ONLY
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
Enumeration date
07/31/2013
Last updated
07/01/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up