NPIMap

Organization Active NPI

Charles Blons, PLLC

  • Psychologist
  • Bloomington, MN
National Provider Identifier
1326090317
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4351 Issued in MN
Legal business name
CHARLES BLONS, PLLC
Practice address
9001 E Bloomington Fwy
Suite 139
Bloomington, MN 55420-3435
Phone
(952) 881-6797
Fax
(952) 881-2028
NPI assigned
May 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Authorized official

Name
Dr. Charles Roderick Blons, PH.D., L.P.
Title
President
Phone
(952) 881-6797

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X LP4351 MN Primary

Addresses

Primary practice location

9001 E Bloomington Fwy
Suite 139
Bloomington, MN 55420-3435

Mailing address

9001 E Bloomington Fwy
Suite 139
Bloomington, MN 55420-3435
Phone (952) 881-6797

Other identifiers 3

IdentifierTypeStateIssuer
295L6BLOtherMNBLUE CROSS BLUE SHIELD
30247-02OtherMNPREFERRED ONE
430048300MedicaidMN

National Provider Directory

National Provider Directory

Locations

9001 E Bloomington Fwy
Ste 139
Bloomington, MN 55420
Phone (952) 881-6797

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1326090317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9001 E BLOOMINGTON FWY",
            "address_2": "SUITE 139",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203435",
            "telephone_number": "952-881-6797",
            "fax_number": "952-881-2028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 E BLOOMINGTON FWY",
            "address_2": "SUITE 139",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554203435",
            "telephone_number": "952-881-6797",
            "fax_number": "952-881-2028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES BLONS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "BLONS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "RODERICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-881-6797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., L.P."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "295L6BL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "30247-02",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "430048300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.