Active NPI
Karen Bludorn
- Clinical Social Worker
- Mesa, AZ
National Provider Identifier
1245612480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-15634
- Practice address
- 840 E McKellips Rd Ste 110
Mesa, AZ 85203-9654 - Phone
- (602) 470-5520
- Fax
- (480) 649-0783
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-15634 | AZ | Primary |
Addresses
Primary practice location
840 E McKellips Rd Ste 110
Mesa, AZ 85203-9654
Mailing address
2929 E Thomas Rd
Phoenix, AZ 85016-8034
Phone (602) 470-5043
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-15634 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1295968162
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1245612480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2929 E THOMAS RD",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850168034",
"telephone_number": "602-470-5043",
"fax_number": "602-470-5064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 E MCKELLIPS RD STE 110",
"city": "MESA",
"state": "AZ",
"postal_code": "852039654",
"telephone_number": "602-470-5520",
"fax_number": "480-649-0783"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUDORN",
"first_name": "KAREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-06-24",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW-15634",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.