Individual provider Active NPI

Joshua Bluell, PTA

  • Physical Therapy Assistant
  • Crown Point, IN
National Provider Identifier
1386005866
Registry record updated Mar 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
06004646A Issued in IN
Practice address
12800 Mississippi Pkwy
Suite A201
Crown Point, IN 46307-6900
Phone
(219) 921-1444
Fax
(219) 926-6926
NPI assigned
Mar 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 06004646A IN Primary

Addresses

Primary practice location

12800 Mississippi Pkwy
Suite A201
Crown Point, IN 46307-6900

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (219) 365-6560

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
06004646AINMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1386005866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878",
            "telephone_number": "219-365-6560",
            "fax_number": "219-365-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MISSISSIPPI PKWY",
            "address_2": "SUITE A201",
            "city": "CROWN POINT",
            "state": "IN",
            "postal_code": "463076900",
            "telephone_number": "219-921-1444",
            "fax_number": "219-926-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUELL",
        "first_name": "JOSHUA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-11",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06004646A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crown Point, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.