Karlie Anne Blaz

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160009515 Issued in IL

Practice address

2323 Texas St
Pecos, TX 79772-7338

Phone

(432) 447-3551

NPI assigned

Mar 3, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/16860/brand/1/csg/1/fhir/r4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1013664655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2323 TEXAS ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797727338",
            "telephone_number": "815-354-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2323 TEXAS ST",
            "city": "PECOS",
            "state": "TX",
            "postal_code": "797727338",
            "telephone_number": "432-447-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZ",
        "first_name": "KARLIE",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160009515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenniffer Jean Musong Auxtero
• Eric Awuah
• Won Joo Bang, M.D.
• Sanat R Bhatt, PT, MS
• Bruno Bittencourt Dos Santos, MD
• Tanya Burks, DNP
• Pete Castillo, PA-C
• Ola Gail Caverly, M.D.
• Orville D Cerna, M.D.
• County of Reeves

• All providers in Pecos, TX
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.