Individual provider Active NPI

Robert C Blodgett, C.A.T.C.

  • Addiction (Substance Use Disorder) Counselor
  • Auburn, CA
National Provider Identifier
1124290911
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
040890 Issued in CA
Practice address
11512 B Ave
Auburn, CA 95603-2605
Phone
(530) 886-2933
NPI assigned
Apr 1, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 040890 CA Primary

Addresses

Primary practice location

11512 B Ave
Auburn, CA 95603-2605

Mailing address

18242 Mountain Park CT
Grass Valley, CA 95949-9037
Phone (530) 268-2450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
040890CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1124290911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18242 MOUNTAIN PARK CT",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959499037",
            "telephone_number": "530-268-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11512 B AVE",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032605",
            "telephone_number": "530-886-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLODGETT",
        "first_name": "ROBERT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "C.A.T.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-01",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "040890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.