Mr. Jack Colt Blaine is a Albuquerque, New Mexico based nurse anesthetist with 36 years of experience as Anesthesia Administration. He completed he graduation in 1989. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mr. Jack Colt Blaine is CRNA00868 for Anesthesia Administration in New Mexico. his current practice location is 6709 Academy Rd Ne Ste A, Albuquerque. Patients can reach him at 505-312-4712. Mr. Jack Colt Blaine is CRNA with specialization in Anesthesia Administration and he NPI number (Unique professional ID assigned by NPPES) is 1811999642. Mr. Jack Colt Blaine is a certified registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists.
Complete Profile:
Mr. Jack Colt Blaine speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Anesthesia Administration
Credentials:
CRNA
Experience:
36+ years
Medical School Attended:
Other
Graduation Year:
1989
Gender:
Male
Accepts Medicare Assignment:
Yes
Practice Address:
6709 Academy Rd Ne Ste A, Albuquerque, New Mexico, 87109-3363
Phone:
505-312-4712
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
PAC ID:
6800831579
Enrollment ID:
I20050822000798
NPI Number:
1811999642
NPI Enumeration Date:
11 Aug, 2005
NPI Last Update On:
19 Jan, 2022
Medical Licenses:
Nurses can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. Jack Colt Blaine are as mentioned below.
License Number
Specialization
State
Status
CRNA00868
Anesthesia Administration
New Mexico
Primary
CRNA0061
Anesthesia Administration
Arizona
Secondary
AP108435
Anesthesia Administration
Texas
Secondary
NA1771
Anesthesia Administration
California
Secondary
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
Hospital Name (CCN)
State
Hospital Type
Yuma Regional Medical Center (030013)
Yuma, AZ
Acute Care Hospital
Group Practice:
Group practices are run by a group of physicians who share their premises and other resources. Following list states all the group name
with which Mr. Jack Colt Blaine has association with along with the number of members in that group.
Organization Name (Group PAC ID)
Members
Main Street Anesthesia Of New Mexico, Llc (3476807538)
135
Yuma Regional Medical Center (2062314826)
220
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
36720 Palm Ct, Rancho Mirage, California
Zip:
92270-2206
Phone Number:
619-994-2941
Fax Number:
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Patients can reach Mr. Jack Colt Blaine at 6709 Academy Rd Ne Ste A, Albuquerque, New Mexico or can call to book an appointment on 505-312-4712.
Comments/ Reviews:
Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.