Individual provider Active NPI

Richard Albert Blase, DC

  • Chiropractor
  • Asheboro, NC
National Provider Identifier
1336242668
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
882 Issued in NC
Practice address
177 NC Highway 42 N Ste a
Asheboro, NC 27203-7955
Phone
(336) 625-1750
Fax
(336) 629-7650
NPI assigned
Sep 5, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 882 NC Primary

Addresses

Primary practice location

177 NC Highway 42 N Ste a
Asheboro, NC 27203-7955

Mailing address

177-A North Carolina Highway 42 North
Asheboro, NC 27203
Phone (336) 625-1750

Other identifiers 1

IdentifierTypeStateIssuer
8908262MedicaidNC

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

LicenseStateTypeSpecialty
882NCMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336242668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177-A NORTH CAROLINA HIGHWAY 42 NORTH",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "27203",
            "telephone_number": "336-625-1750",
            "fax_number": "336-629-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 NC HIGHWAY 42 N STE A",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "272037955",
            "telephone_number": "336-625-1750",
            "fax_number": "336-629-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLASE",
        "first_name": "RICHARD",
        "middle_name": "ALBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908262",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.