Individual provider Active NPI

Jeffrey R. Blood, MD

  • Physical Medicine & Rehabilitation Physician
  • Venice, FL
National Provider Identifier
1255331476
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
ME94683 Issued in FL
Practice address
1790 E Venice Ave Ste 102
Venice, FL 34292-3191
Phone
(941) 483-9730
Fax
(941) 483-9745
NPI assigned
Jul 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X ME94683 FL Primary

Addresses

Primary practice location

1790 E Venice Ave Ste 102
Venice, FL 34292-3191

Mailing address

614 Ravenna St
Venice, FL 34285-3028
Phone (941) 483-9730

Other identifiers 1

IdentifierTypeStateIssuer
001861600MedicaidFL

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME94683FLMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emg and Rehabilitation Assoc., Inc. Physical Medicine & Rehabilitation CurrentSince Jan 1, 1980 Accepting new patients

Locations

200 Bradenton Ave
Dublin, OH 43017
Phone (614) 793-1080

568 S Cleveland Ave
Ste B
Westerville, OH 43081
Phone (614) 895-3344

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.

NPI Registry JSON

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1255331476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 RAVENNA ST",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853028",
            "telephone_number": "941-483-9730",
            "fax_number": "941-483-9745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 E VENICE AVE STE 102",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923191",
            "telephone_number": "941-483-9730",
            "fax_number": "941-483-9745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOD",
        "first_name": "JEFFREY",
        "middle_name": "R.",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-29",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "FL",
            "license": "ME94683",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001861600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.