Mary A Blattner, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

22983 Issued in CO

Practice address

5881 W 16TH St
Greeley, CO 80634-2910

Phone

(970) 313-2734

Fax

(970) 313-2733

NPI assigned

Dec 30, 2005

Last updated

Jul 1, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  NPD
• Poudre Valley Medical Group, LLC

  dba UCHealth Medical Group

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1205813193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2734",
            "fax_number": "970-313-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5881 W 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806342910",
            "telephone_number": "970-313-2734",
            "fax_number": "970-313-2733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLATTNER",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "22983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01229830",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER PTAN",
            "identifier": "P00944855",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew A Bland, DDS
• Lisa Blank, PH.D.
• Chris Blaser, ATC
• Malachi Blaszkowski
• Melissa Blatnik, BA, CAC III
• Shantel Blea
• Julie Bledsoe, MA, LPC
• Sheena L Bledsoe, PHYSICIAN ASSISTANT
• Katherine Bliss, CRNA
• Karsen Blochowitz, RBT

• Dermatology Physician in Greeley, CO
• Providers in Greeley, CO by specialty
• Dermatology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.