Active NPI
Jason Blunck
- Home Health Aide
- Decatur, IL
National Provider Identifier
1215634589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Aide
- License
- 3002398
- Practice address
- 1398 N Oakland Ave
Decatur, IL 62526-3737 - Phone
- (217) 429-6666
- NPI assigned
- Feb 7, 2023
- Last updated
- Feb 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | |||
| Home Health Aide | 374U00000X | 3002398 | IL | Primary |
Addresses
Primary practice location
1398 N Oakland Ave
Decatur, IL 62526-3737
Mailing address
1398 N Oakland Ave
Decatur, IL 62526-3737
Phone (217) 429-6666
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3002398 | IL | MD | Home Health Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blunck2604Llc | Current | Accepting new patients | |
| Clark Enterprises 407 LLC | Past | Accepting new patients | |
| Clark Enterprises 407 LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba Comfort Keepers
- In Home Supportive Care Agency
- Decatur, IL
- NPI 1740432152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1215634589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1398 N OAKLAND AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625263737",
"telephone_number": "217-429-6666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1398 N OAKLAND AVE",
"city": "DECATUR",
"state": "IL",
"postal_code": "625263737",
"telephone_number": "217-429-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUNCK",
"first_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-07",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": null,
"license": null,
"primary": false
},
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": "IL",
"license": "3002398",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.