Active NPI
Deborah Joanne Blaylock, AUD
- Audiologist
- Peoria, AZ
National Provider Identifier
1447438130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- DA1454
- Practice address
- 13090 N 94TH Dr Ste 202
Peoria, AZ 85381-4258 - Phone
- (480) 712-2206
- NPI assigned
- Feb 5, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | DA1454 | AZ | Primary |
Addresses
Primary practice location
13090 N 94TH Dr Ste 202
Peoria, AZ 85381-4258
Mailing address
9146 W Via del Sol
Peoria, AZ 85383-3544
Phone (602) 690-4108
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA1454 | AZ | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1202169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690243200000",
"number": "1447438130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9146 W VIA DEL SOL",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853833544",
"telephone_number": "602-690-4108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13090 N 94TH DR STE 202",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853814258",
"telephone_number": "480-712-2206"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAYLOCK",
"first_name": "DEBORAH",
"middle_name": "JOANNE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-05",
"last_updated": "2023-07-25",
"certification_date": "2023-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AZ",
"license": "DA1454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.