Evan Blazek

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

402 W College Ave Unit 2622
Ada, OH 45810-6109

Phone

(317) 474-5402

NPI assigned

Aug 28, 2025

Last updated

Aug 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1756339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1164301677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 S GILBERT ST",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458101311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W COLLEGE AVE UNIT 2622",
            "city": "ADA",
            "state": "OH",
            "postal_code": "458106109",
            "telephone_number": "317-474-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAZEK",
        "first_name": "EVAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-28",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Akeem A Adeniyi, CNP
• Nicholas Alger, LMT.
• Becky Jo Armentrout, OT
• Katherine Badertscher, MSW, LISW-S
• Marcey Bell, LISWS
• Mackenzie Elizabeth Bosold
• Connor Edward Bowers, RPH
• Brooke Buroker, LPN
• Edmond Chin, PHARM.D.
• Community Health Professionals, Inc. (Ada Visiting Nurses)

• Student in an Organized Health Care Education/Training Program in Ada, OH
• Providers in Ada, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2025; 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.