BLAKE THOMPSON NPI 1134624687

NPI Information

  • NPI: 1134624687
  • Provider Name: BLAKE THOMPSON
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1340 S 18TH ST STE 204
    FERNANDINA BEACH, FL
    ZIP 32034
  • Phone: (904) 398-7205

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NPI Details

Blake Thompson is a gastroenterology internal medicine in Fernandina Beach, FL with 8 years of experience. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. Blake Thompson NPI is 1134624687. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
Graduation Year:2018

The provider's business location address is:

1340 S 18TH ST STE 204
FERNANDINA BEACH, FL
ZIP 32034-733
Phone: (904) 398-7205
Fax: (904) 277-7054

The NPI 1134624687 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 3/27/2018 and was last updated on 6/3/2024.

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
1207RG0100XInternal MedicineGastroenterologyME167699FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1122460200MEDICAIDFLORIDA

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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