Mark Stephen Blue

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

CO8384 Issued in CO

Practice address

555 S. Camino del Rio
B1
Durango, CO 81303

Phone

(970) 385-6800

Fax

(970) 385-4620

NPI assigned

Nov 7, 2005

Sex

Male

Sole proprietor

No

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1033190251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S. CAMINO DEL RIO",
            "address_2": "B1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813034244",
            "telephone_number": "970-385-6800",
            "fax_number": "970-385-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S. CAMINO DEL RIO",
            "address_2": "B1",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "81303",
            "telephone_number": "970-385-6800",
            "fax_number": "970-385-4620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3057 Main Ave",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813014244",
            "country_code": "US",
            "telephone_number": "970-385-6800",
            "fax_number": "970-385-4620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUE",
        "first_name": "MARK",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "CO8384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nattalie Swartz Blau, MS, LPC
• Claudia Gugel Bleth, LAC, RN
• Field T Blevins, MD
• Elizabeth Bloom, RDN
• Blue Sky Behavioral Health Services
• Rebekah Blythe, C.P.M.
• Body Wellness LLC
• Laura Jean Boe, MA
• Cyril Bohachevsky, M.D.
• Eleanor Bolster, SWC

• Periodontics in Durango, CO
• Providers in Durango, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.