Individual provider Active NPI

Gregory Paul Blimling, PSYD

  • Psychologist
  • Denver, CO
National Provider Identifier
1366987075
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
5506 Issued in CO
Practice address
660 Bannock St
Denver, CO 80204-4506
Phone
(303) 602-4844
NPI assigned
Jan 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 5506 CO Primary
Clinical Psychologist 103TC0700X 021978 NY

Addresses

Primary practice location

660 Bannock St
Denver, CO 80204-4506

Mailing address

660 Bannock St
Denver, CO 80204-4506
Phone (303) 602-4844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, CO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170224000078 NY Practitioner - Clinical Psychologist 2264716968 Reassigns benefits to 1 organization
I20211119001571 CO Practitioner - Clinical Psychologist 2264716968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5506COMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College Psychologist CurrentSince Jan 16, 2017 Accepting new patients
Albany Medical College CurrentSince May 1, 2019 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 1, 2021 Accepting new patients
Albany Medical College CurrentSince Jan 16, 2017 Accepting new patients
Denver Health and Hospital Authority CurrentSince Sep 1, 2021 Accepting new patients

Locations

777 Bannock St
Denver, CO 80204

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

25 Hackett Blvd
Albany, NY 12208
Phone (518) 262-1200

Organizations & group practices 5

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": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1366987075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BANNOCK ST",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802044506",
            "telephone_number": "303-602-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLIMLING",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "5506",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.