IndividualActive
Beau Blake
NPI 1417830811 · Pharmacist · Madison, WI
Beau Blake is a Pharmacist provider in Madison, WI (NPI 1417830811).
Provider details
- NPI number
- 1417830811
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 22042 (WI)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4602 Eastpark Blvd
Madison, WI 53718-2002
Phone: (608) 440-6400
Street-level locationGet directions
Mailing address
1010 E Washington Ave Apt 1019
Madison, WI 53703-4414
Registry dates
- Enumerated
- 2025-07-31
- Last updated
- 2025-07-31
- Certified
- 2025-07-31
Frequently asked questions
- What is Beau Blake's NPI number?
- Beau Blake's National Provider Identifier (NPI) is 1417830811, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Beau Blake's specialty?
- Beau Blake is listed in the NPPES registry with a primary specialty of Pharmacist (Pharmacy Service Providers).
- Where is Beau Blake located?
- Beau Blake's practice location on file with NPPES is 4602 Eastpark Blvd, Madison, WI 53718-2002.
- What is Beau Blake's phone number?
- The practice phone number listed in the NPPES registry for Beau Blake is (608) 440-6400.
- Is Beau Blake's NPI active?
- Yes — Beau Blake's NPI (1417830811) is active in the NPPES registry as of the last update on 2025-07-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.