Individual provider Active NPI

Sonya A Bladow, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1295984987
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7965 Issued in AZ
Practice address
11209 N Tatum Blvd
Ste 140
Phoenix, AZ 85028-3091
Phone
(480) 368-2639
Fax
(480) 368-2643
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7965 AZ Primary

Addresses

Primary practice location

11209 N Tatum Blvd
Ste 140
Phoenix, AZ 85028-3091

Mailing address

11209 N Tatum Blvd
Ste 140
Phoenix, AZ 85028-3091
Phone (480) 368-2639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081114000777 AZ Practitioner - Chiropractic 5496815839 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7032 E Cochise Rd
A130
Scottsdale, AZ 85253-1454
Phone (480) 368-2639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7965AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Total Lifestyle Chiropractic PLLC Chiropractor CurrentSince Nov 14, 2008 Accepting new patients

Locations

7032 E Cochise Rd
Ste A130
Scottsdale, AZ 85253
Phone (480) 368-2639

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1295984987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD",
            "address_2": "STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283091",
            "telephone_number": "480-368-2639",
            "fax_number": "480-368-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11209 N TATUM BLVD",
            "address_2": "STE 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850283091",
            "telephone_number": "480-368-2639",
            "fax_number": "480-368-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLADOW",
        "first_name": "SONYA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.