BLAKE FLETCHER – Physical Therapist, NPI 1124855051

BLAKE FLETCHER is a healthcare provider. based in Louisville, Kentucky. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. PT61595722 (WA). The NPI Number for BLAKE FLETCHER is 1124855051

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
BLAKE FLETCHER
NPI
1124855051
Phone
(726) 202-3039
Address
1650 LYNDON FARM CT STE 300
Enumeration Date
16 September 2024
Last Update Date
16 September 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2537505997
Graduation Year
2024 (2 years ago)
PAC ID
1759812530
Group Practice PAC ID
2668540337
Professional Enrollment ID
I20241003002499
Address ID
WA983917901BO19910EXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

3,527 PHYSICAL THERAPIST IN PRIVATE PRACTICE in WA

Provider Addresses for BLAKE FLETCHER

  • 1650 LYNDON FARM CT STE 300

    LOUISVILLE, KY 402235005

    Phone: (726) 202-3039

    Type: Mailing

  • 814 DUPONT ST

    BELLINGHAM, WA 982253103

    Phone: (360) 671-2900

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241003002499IPhysical Therapist In Private PracticeWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40223)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2668540337View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA
Physical Therapist In Private PracticeWA

Reviews

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Frequently asked questions

Does BLAKE FLETCHER have a public NPI I can cite?
Public records show BLAKE FLETCHER under NPI 1124855051.
Quick check: is BLAKE FLETCHER active?
Public NPPES data shows BLAKE FLETCHER with an active NPI status right now.
What services align with BLAKE FLETCHER's listing?
BLAKE FLETCHER's public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What geographic area is tied to BLAKE FLETCHER?
BLAKE FLETCHER is associated with Louisville, Kentucky in the same public data insurers reference.
Why is information missing for BLAKE FLETCHER?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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