Active NPI
Eric Nils Lundblom, LMSW
- Social Worker
- Du Bois, PA
National Provider Identifier
1275977431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M5118
- Practice address
- 5690 Shaffer Rd
Du Bois, PA 15801-3870 - Phone
- (814) 375-6817
- Fax
- (814) 375-0922
- NPI assigned
- Apr 18, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | M5118 | OR | Primary |
Addresses
Primary practice location
5690 Shaffer Rd
Du Bois, PA 15801-3870
Mailing address
5690 Shaffer Rd
Du Bois, PA 15801-3870
Phone (814) 375-6817
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 |
|---|---|---|---|
| M5118 | OR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366243200000",
"number": "1275977431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5690 SHAFFER RD",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158013870",
"telephone_number": "814-375-6817",
"fax_number": "814-375-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5690 SHAFFER RD",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158013870",
"telephone_number": "814-375-6817",
"fax_number": "814-375-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNDBLOM",
"first_name": "ERIC",
"middle_name": "NILS",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-04-18",
"last_updated": "2013-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OR",
"license": "M5118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.