Kevin W. Blechle, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02836 Issued in IA

Practice address

5359 Eastern Ave
Davenport, IA 52807-2738

Phone

(563) 742-5900

Fax

(563) 742-5905

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Lutheran Home for the Aged Association-East

  • Skilled Nursing Facility
  • Davenport, IA
  • NPI 1730259813

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

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.

• Iowa Physicians Clinic Medical Foundation

  • General Practice Physician
  • West Des Moines, IA
  • NPI 1366425274
  Medicare reassignment
• Aras Family Care, P. C.

  • Family Medicine Physician
  • Davenport, IA
  • NPI 1891842373
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1396725768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5359 EASTERN AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072738",
            "telephone_number": "563-742-5900",
            "fax_number": "563-742-5905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5359 EASTERN AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072738",
            "telephone_number": "563-742-5900",
            "fax_number": "563-742-5905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLECHLE",
        "first_name": "KEVIN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "02836",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-102383",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-102383",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00055265",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396725768",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Bjurstrom, ATC
• Joan Irene Blair-Dick, LMSW
• Lauren Payton Blake
• Shane Blakeley
• Gregory L Blaske, P.T.
• Nicholas Blieu, ARNP
• Lynne Annette Blind, D.C.
• Timothy Michael Block, ATC, PTA
• Kisha Kay Blunk, ARNP, FNP
• Richard Carl Blunk, M.D.

• Family Medicine Physician in Davenport, IA
• Providers in Davenport, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.