Individual provider Active NPI

Allison Blair Blunden, PA-C

  • Physician Assistant
  • Bradenton, FL
National Provider Identifier
1104149327
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104815 Issued in FL
Practice address
11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone
(941) 538-0001
Fax
(941) 538-0002
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104815 FL Primary
Medical Physician Assistant 363AM0700X PA9104815 FL

Addresses

Primary practice location

11715 Rangeland Pkwy
Bradenton, FL 34211-9529

Mailing address

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0001

Other names 1

  • Allison Blair Taylor Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Allison.Blunden@img.directbygreenway.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111031000275 FL Practitioner - Physician Assistant 9335312701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Intercoastal Medical Group IncGroup PAC ID 6305730912, 176 clinicians

Practice addresses (Care Compare)

11715 Rangeland Pkwy
Bradenton, FL 34211-9529
Phone (941) 538-0001

921 S Beneva Rd
Sarasota, FL 34232-2401
Phone (941) 365-7390

965 S Beneva Rd
Sarasota, FL 34232-2401
Phone (941) 366-1888

Hospital & facility affiliations

  • Patients First Home Care LLC Home health agency, Bradenton, FL, CCN 687173
  • Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299
  • Sarasota Memorial Hospital Hospital, Sarasota, FL, CCN 100087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9104815FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Intercoastal Medical Group Inc CurrentSince Mar 5, 2023 Accepting new patients

Locations

11715 Rangeland Pkwy
Bradenton, FL 34211
Phone (941) 538-0001

943 S Beneva Rd
Ste 306
Sarasota, FL 34232
Phone (941) 362-8644

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.70573
  • Direct secure messaging: allison.blunden@img.directbygreenway.com

Organizations & group practices 2

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

Hospital & facility affiliations 4

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": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1104149327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0001",
            "fax_number": "941-538-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11715 RANGELAND PKWY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342119529",
            "telephone_number": "941-538-0001",
            "fax_number": "941-538-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUNDEN",
        "first_name": "ALLISON",
        "middle_name": "BLAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104815",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9104815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Allison.Blunden@img.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11715 Rangeland Pkwy",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342119529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "TAYLOR",
            "middle_name": "BLAIR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.