Jeffrey K Blixt, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38650 Issued in CO

Practice address

1715 N Weber St Ste 260
Colorado Springs, CO 80907-7553

Phone

(719) 896-4794

Fax

(719) 896-5484

NPI assigned

Jul 14, 2006

Reactivated

Feb 27, 2009

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 1, 2018 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JK Blixt D.O. Inc

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1619129269
  Authorized official Same address or phone

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063438869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST STE 260",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077553",
            "telephone_number": "719-896-4794",
            "fax_number": "719-896-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N WEBER ST STE 260",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809077553",
            "telephone_number": "719-896-4794",
            "fax_number": "719-896-5484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 Security Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809111728",
            "country_code": "US",
            "telephone_number": "719-392-1441 x11",
            "fax_number": "719-392-6044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "417 Security Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809111728",
            "country_code": "US",
            "telephone_number": "719-392-1441 x11",
            "fax_number": "719-392-6044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLIXT",
        "first_name": "JEFFREY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2018-03-17",
        "deactivation_date": "2008-10-16",
        "reactivation_date": "2009-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "38650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17204062",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adam D Bliss, NP
• Chloe Marguerite Bliss
• David Paul Bliss Jr., M.D.
• Mikaela Sage Bliss
• Jason Bernard Blitz, M.D.
• Emily Christine Blohm, M.S. CCC- SLP
• Eric E Blom, MD
• Alexandra Blomquist, DDS
• Ronald D Blonder, D.O.
• Neida L. Blondet, MSN, APRN, FNP-C

• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.