NPIMap

Organization Active NPI

Chambers & Blohm Psychological

  • Clinical Psychologist
  • Bismarck, ND
National Provider Identifier
1114045465
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
CHAMBERS & BLOHM PSYCHOLOGICAL
Practice address
309 N Mandan St Ste 1
Bismarck, ND 58501-3886
Phone
(701) 323-0924
Fax
(701) 323-0935
NPI assigned
Mar 26, 2007
Last updated
Apr 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Authorized official

Name
Dr. Kathy BlohmNPI 1225153968
Title
Owner
Phone
(701) 323-0924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary
Clinical Social Worker 1041C0700X NU

Addresses

Primary practice location

309 N Mandan St Ste 1
Bismarck, ND 58501-3886

Mailing address

309 N Mandan St Ste 1
Bismarck, ND 58501-3886
Phone (701) 323-0924

Other identifiers 2

IdentifierTypeStateIssuer
2045001OtherNDBCBS OF NORTH DAKOTA
12294MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000177 ND Part B Supplier - Clinic/Group Practice 1456248004 Receives reassigned benefits from 7 practitioners
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

1701 Burnt Boat Dr
Bismarck, ND 58503
Phone (701) 323-0924

309 N Mandan St
Ste 1
Bismarck, ND 58501
Phone (701) 323-0924

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23247/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554076800000",
    "number": "1114045465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 N MANDAN ST STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013886",
            "telephone_number": "701-323-0924",
            "fax_number": "701-323-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N MANDAN ST STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013886",
            "telephone_number": "701-323-0924",
            "fax_number": "701-323-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMBERS & BLOHM PSYCHOLOGICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2019-04-01",
        "status": "A",
        "authorized_official_last_name": "BLOHM",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-323-0924",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NORTH DAKOTA",
            "identifier": "2045001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12294",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.