NPIMap

Individual provider Active NPI

David J Blazer, MD

  • Cardiovascular Disease Physician
  • Dickson, TN
National Provider Identifier
1093718272
Registry record updated Aug 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD26023 Issued in TN
Practice address
113 Highway 70 E
Dickson, TN 37055-2080
Phone
(615) 441-4450
Fax
(615) 446-1357
NPI assigned
May 23, 2005
Last updated
Aug 12, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD26023 TN Primary
Interventional Cardiology Physician 207RI0011X MD26023 TN

Addresses

Primary practice location

113 Highway 70 E
Dickson, TN 37055-2080

Mailing address

127 Crestview Park Dr
Dickson, TN 37055-2855
Phone (615) 446-5121

Other identifiers 3

IdentifierTypeStateIssuer
3158418OtherTNBLUE CROSS BLUE SHIELD TN
060061304OtherRAILROAD MEDICARE PIN
3086151MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303000493 TN Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6305935792 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dickson Medical Associates, PCGroup PAC ID 3971408774, 55 clinicians

Practice addresses (Care Compare)

113 Hwy 70 E
Dickson, TN 37055-2075
Phone (615) 446-5121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD26023TNMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dickson Medical Associates PC Current Accepting new patients
Dickson Medical Associates, PC CurrentSince Jan 1, 2001 Accepting new patients
Dickson Medical Associates, PC CurrentSince Jan 1, 2001 Accepting new patients

Locations

113 Highway 70 E
Dickson, TN 37055
Phone (615) 446-5121

113 Highway 70 E
Fl 3
Dickson, TN 37055
Phone (615) 441-4450

113 Highway 70 E
Ste MH3
Dickson, TN 37055

127 Crestview Park Dr
Dickson, TN 37055
Phone (615) 441-4478

Interoperability endpoints

  • Direct secure messaging: dblazer26959@dicksonmedicalassociates.gardenplot.direct-ci.com

Ownership & related parties

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Dickson Medical Associates, PCWaverly, TN, CCN 448958 Rural health clinic General Partnership Interest (4.43%) Jan 1, 2001
Dma South PediatricsDickson, TN, CCN 883843 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001
Dickson Medical Associate White BluffWhite Bluff, TN, CCN 883842 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001
Dickson Medical Associates Crestview Walk-inDickson, TN, CCN 883854 Rural health clinic 5% Or Greater Direct Ownership Interest (7.04%) Jan 1, 2004
Dickson Medical Associates, PCFairview, TN, CCN 883917 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001
Dma Pediatrics and Specialty ClinicWaverly, TN, CCN 883924 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001
First Priority HealthHohenwald, TN, CCN 883955 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001
Dickson Medical Associates, PCAshland City, TN, CCN 883965 Rural health clinic 5% Or Greater Direct Ownership Interest (7.04%) Jan 1, 2001
Dickson Medical Associates, PCKingston Springs, TN, CCN 883966 Rural health clinic 5% Or Greater Direct Ownership Interest (7.04%) Jan 1, 2001
Dma SouthDickson, TN, CCN 888923 Rural health clinic 5% Or Greater Direct Ownership Interest (4.43%) Jan 1, 2001

Owned or controlled facilities with NPI records 11

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439337600000",
    "number": "1093718272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 CRESTVIEW PARK DR",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552855",
            "telephone_number": "615-446-5121",
            "fax_number": "615-446-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 HIGHWAY 70 E",
            "city": "DICKSON",
            "state": "TN",
            "postal_code": "370552080",
            "telephone_number": "615-441-4450",
            "fax_number": "615-446-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZER",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2015-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TN",
            "license": "MD26023",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TN",
            "license": "MD26023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TN",
            "identifier": "3158418",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "060061304",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086151",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickson, TN

Sources for this page

Verify at the official NPI Registry.