Active NPI
Gary Eldon Blunt, RN
- Registered Nurse
- North Hollywood, CA
National Provider Identifier
1013749837
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 818001
- Practice address
- 5121 Klump Ave Apt 214
North Hollywood, CA 91601-4904 - Phone
- (424) 731-2249
- Fax
- (562) 402-3336
- NPI assigned
- Aug 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 818001 | CA | |
| Hospice Registered Nurse | 163WH1000X | 818001 | CA | |
| Registered Nurse | 163W00000X | 818001 | CA | Primary |
Addresses
Primary practice location
5121 Klump Ave Apt 214
North Hollywood, CA 91601-4904
Mailing address
5315 Torrance Blvd Ste B1
Torrance, CA 90503-4011
Phone (800) 829-8660
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gary.blunt@providence.org | Direct | Providence Health & Services - Washington |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 818001 | CA | MD | Hospice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724025600000",
"number": "1013749837",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5315 TORRANCE BLVD STE B1",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905034011",
"telephone_number": "800-829-8660",
"fax_number": "562-402-3336"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5121 KLUMP AVE APT 214",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916014904",
"telephone_number": "424-731-2249",
"fax_number": "562-402-3336"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUNT",
"first_name": "GARY",
"middle_name": "ELDON",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-08-19",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "CA",
"license": "818001",
"primary": false
},
{
"code": "163WH1000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hospice",
"state": "CA",
"license": "818001",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "818001",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gary.blunt@providence.org",
"affiliation": "Y",
"endpointDescription": "Work Email",
"affiliationName": "Providence Health & Services - Washington",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "5633 N Lidgerwood St",
"city": "Spokane",
"state": "WA",
"country_code": "US",
"postal_code": "992081224",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in North Hollywood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.