BLAKE ALEXANDER MEDLEY NPI 1043880834

NPI Information

  • NPI: 1043880834
  • Provider Name: BLAKE ALEXANDER MEDLEY
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 204 SHAVER DR
    TALBOTT, TN
    ZIP 37877
  • Phone: (423) 581-7040

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NPI Details

Blake Alexander Medley is a physician assistant in Talbott, TN with 5 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Blake Alexander Medley NPI is 1043880834. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

204 SHAVER DR
TALBOTT, TN
ZIP 37877-552
Phone: (423) 581-7040
Fax: (423) 581-9563

The NPI 1043880834 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/25/2021 and was last updated on 6/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician Assistant4617TENNESSEEYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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